Staff Utilization Management Clinical Pharmacist

Remote, USA Full-time
**Overview:** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. **Responsibilities:** • Conduct medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization • Evaluate complex clinical scenarios and apply evidence-based criteria to ensure appropriate medication use • Address moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors • Intervene and provide clinical guidance to patients and providers to support cost-effective medication use and promote high-quality patient outcomes • Identify unusual usage patterns and analyze overall utilization to support optimal medication use • *Qualifications:** • Bachelor's degree or Doctor of Pharmacy (Pharm.D.) from an accredited college of pharmacy • Active pharmacist license in the state of residence • Eligibility to participate in federal prescription programs (e.g., Medicare/Medicaid) • Self-directed with the ability to work effectively both independently and in a team environment • Strong problem-solving skills and the ability to foster collaborative solutions • High attention to detail with a strong work ethic focused on accuracy and productivity • Excellent verbal and written communication skills • Proficiency with computer systems, including but not limited to: + Microsoft Office Suite (Word, Excel, Outlook) + Clinical decision support tools (e.g., Micromedex, Lexicomp) + Pharmacy benefit management (PBM) platforms + Electronic health records (EHRs) • *Benefits:** • Competitive salary range: $104,000 - $143,000 per year • Bonuses and incentives • Comprehensive medical, dental, and vision benefits • 401(k) retirement savings plan • Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) • Short-term and long-term disability • Life insurance • And many other opportunities to support whole-person well-being Apply tot his job
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