Clinical Pharmacist Utilization Management

Job Summary

A company is looking for a Clinical Pharmacist - Utilization Management.

Key Responsibilities:

• Reviewing prior authorizations requests for drugs and equipment covered under the part B benefit
• Reviewing appeals of previously denied requests
• Ensuring members understand their benefits and providing support for internal staff in understanding policies and procedures

Required Qualifications:

• 2+ years of utilization management experience or completion of a managed care residency
• Appreciation of Medicare regulations and policies
• Experience with pharmacy-related quality assurance work
• Experience working as part of a multidisciplinary care team
• Doctorate of Pharmacy degree and active licensure in at least one state