State Licensed Utilization Management Pharmacist
Job Summary
To support safe and effective medication use, the remote, temp-to-hire State Licensed Utilization Management Pharmacist will review prior authorization requests, ensure compliance with regulations, and provide expert guidance to members, providers, and pharmacies.
Key responsibilities:
- Review and make timely, evidence-based decisions on prior authorizations, appeals, and override requests
- Ensure compliance with federal, state, and internal regulations across various health plans
- Provide clear support to members and prescribers by responding to clinical inquiries with professionalism
Required qualifications:
- Active, unrestricted pharmacist license
- Bachelor's or Doctor of Pharmacy degree
- Minimum of 6 months to a year of prior authorization or utilization management experience
- Minimum of 2 years of pharmacy practice experience
- Experience in managed care or pharmacy benefit management (PBM)
Complete Job Description
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