Licensed Lead Utilization Management Pharmacist
Job Summary
Overseeing daily clinical pharmacy functions, the remote Lead Utilization Management Pharmacist will manage prior authorization reviews, provide member and provider education, and ensure compliance with medical necessity criteria while supporting the Utilization Management team.
Key responsibilities:
- Perform and oversee clinical pharmacy functions including prior authorization and appeal reviews, and member/provider education calls
- Support the training and development of staff to enhance their skills and knowledge
- Lead projects aimed at improving pharmacy operations and clinical outcomes while collaborating with business and clinical partners
Required qualifications:
- Active, unrestricted pharmacist license
- Bachelor's or Doctor of Pharmacy Degree with 2+ years of pharmacy practice experience
- Experience in customer service, call center, and prior authorization
- Ability to work independently in a remote, high-volume environment
- Willingness to work 2 PM - 11 PM ET shift and participate in weekend and holiday rotation
Complete Job Description
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