New York Licensed Utilization Manager

Job Summary

A company is looking for a Manager, Utilization Management.

Key Responsibilities

• Lead and nurture a team of clinical pharmacists and technicians for the prior authorization and appeals process
• Create and uphold policies and procedures for utilization management review while optimizing workflow
• Manage contracts with external organizations and oversee clinical criteria maintenance

Required Qualifications

• Active, unrestricted pharmacist license required
• Bachelor of Pharmacy or Doctorate of Pharmacy Degree required
• 4+ years of prior authorization experience at a PBM or health plan
• 3+ years of leadership experience preferred
• Experience with multiple lines of business, including Commercial and Medicare Part D, preferred