Clinical Pharmacist - Utilization Management

Job Summary

To support a growing pharmacy benefit management model, the full-time Clinical Pharmacist - Utilization Management will review utilization management requests for clinical appropriateness, coordinate with pharmacy teams, and ensure compliance with state and federal guidelines, all while working remotely.

Key responsibilities

• Review utilization management requests to determine clinical appropriateness and cost-effectiveness
• Coordinate with pharmacy technicians, pharmacists, and medical directors on utilization management activities
• Research and develop therapy-specific clinical policies and utilization management programs

Required qualifications

• Pharmacy Degree required; PharmD preferred
• Minimum of 1 year experience in coordinating medication selection with prescribers; 1-3+ years of managed care experience preferred
• Pharmacist license in good standing in state of residence, with willingness to maintain licensure in multiple states
• Availability to work 40 hours per week during core operating hours, with potential evening or weekend shifts
• Strong knowledge of pharmacy benefits and effective problem-solving skills