Remote Utilization Management Pharmacist
Humana
Humana is seeking a Utilization Management Clinical Pharmacist 2 (VSP/PT) to perform medical necessity reviews and comprehensive medication reviews for prescriptions requiring pre-authorization. The role involves analyzing care plans, identifying unusual usage patterns, and advising patients and providers to promote cost-effective utilization and quality outcomes.
The position is remote with occasional travel to Humana offices for training or meetings, and focuses on ensuring effective
#J-18808-Ljbffr$130k
...Utilization Management Pharmacist (temp-to-hire) Remote About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated...Remote workTemporary workLocal areaFlexible hoursShift workWeekend work- ...in full. Below, you'll find other important information about this position. Reporting to the Manager of Clinical Pharmacy, the Clinical Utilization Management Pharmacist is primarily responsible for performing drug utilization review for initial determinations and/...Remote workWork at officeShift work
$102.7k - $164.6k
...determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information... ...LICENSES OR CERTIFICATIONS Required ~ Registered Pharmacist Preferred ~ None SKILLS Oral & Written Communication...Remote workFull timeFor contractorsWork at officeLocal area$135k - $145k
...Utilization Management Pharmacist Trainer Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United... ...independently with minimal supervision, staying productive in a remote, high-volume, and metric driven call center environment....Remote workWork at officeLocal areaFlexible hours- ...Position Summary The Clinical Pharmacist I is a volume-driven,... ...comprehensive knowledge of modern managed care trends, evolving... ...data, clinical guidelines, and utilization management workflows. Operational... ...individual case reviews. Remote Productivity: Self-motivated,...Remote work
- ...Position Summary The Clinical Pharmacist II is an advanced clinical... ...Pharmacist II specializes in managing clinical escalations, interpreting... ...Effectiveness Synthesis: Utilize comprehensive comparative... ...and defensible rationales. Remote Productivity: Highly organized...Remote work
- ...Remote DUR Pharmacist Safe & Cost-Effective Medication Use Work From Home Analyze medication use... ...all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists... ...S. pharmacist license. Experience: Managed care, PBM, or health-plan preferred....Remote jobWork from home
- JOB SUMMARY:The Utilization Management Clinical Pharmacist is responsible for playing a critical role in optimizing medication use, improving member outcomes... ...and pharmacy information systems. Ability to work remotely will be provided to qualified candidatesOn call...Remote workWork at officeWeekend work
- ...is the industry leader in specialty drug management solutions. Founded with the goal of... ...8am to 5pm Hybrid In Office- 3 Days Remote Work Notification ATTENTION: Archimedes... ...create clinical policies. The Clinical Pharmacist is responsible for being the clinical...Remote workWork at office
- ...About the Job Staff Pharmacist - Independent Pharmacy & Primary Care... ...with physicians, nurses, care managers, and support staff to improve... ...Pharmacy Technology Our pharmacy utilizes: PioneerRx pharmacy... ...Chronic Care Management (CCM). Remote Patient Monitoring (RPM). Medication...Remote workFull timeTemporary workWork at officeMonday to Friday
$60 - $63 per hour
...their customers. From prescription management and pet owner engagement to veterinary... ...! WHO WE ARE LOOKING FOR Remote Clinical Support Pharmacist The Clinical Support... ...intervention, and managing the drug utilization review (DUR) queue. This role creates...Remote workFull timeFlexible hours$55 per hour
...Prior Authorization Pharmacist This position involves reviewing Utilization Management requests such as formulary exceptions, prior authorizations, step therapy,... ...Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position...Remote workContract workTemporary work$55 per hour
...Prior Authorization Pharmacist 100% Remote | Entry-Level | Contract-to-Hire This position involves reviewing Utilization Management requests such as formulary exceptions, prior authorizations, step therapy, and quantity limit exceptions for Medicare members. The...Remote workContract workTemporary work- ...Formulary Management Pharmacist Influence Therapy Access at Scale | Hybrid/Remote Friendly Shape which medications patients can access by evaluating new drugs, analyzing... ...standards. # Provide clinical support for utilization management, prior-authorization criteria, and...Remote work
$52 - $72 per hour
...Job Description Job Description A remote Pharmacist opportunity is available for a contract-to-permanent position supporting Part... ...flexibility to work from home while engaging in critical utilization management and Medicare compliance tasks. Location: ~ Remote (...Remote workPermanent employmentContract workWork from homeMonday to FridayWeekend work$60 - $67.5 per hour
...Job Description Job Description Title: Remote Drug Utilization Review Pharmacist Duration : 3 month Pay Rate: $60-$67.50/hr Location: Remote... ...Strong understanding of medication therapy management and clinical pharmacy practices Knowledge of federal...Remote workNight shiftAfternoon shift$63 per hour
Overview Location: Remote (based in South Carolina) Schedule:... ...include Adherence, Diabetes Management, Fraud Waste & Abuse, Medication... ...(MTM), Retrospective Drug Utilization Review (RDUR), and STARS... ...team is composed of clinical pharmacists, certified pharmacy technicians...Remote workContract workMonday to FridayFlexible hoursShift workRotating shift$50 - $60 per hour
...Piper Companies is seeking a Clinical Pharmacist to join a leading healthcare... ...pharmacy services organization for an remote contract opportunity based in North Carolina... ...Clinical Pharmacist will support pharmacy utilization management activities, evaluate medication...Remote workHourly payLong term contractContract work$55 - $65 per hour
...Job Description Job Description This opportunity is for a Remote Pharmacist focusing on Part B drug and biologic prior authorization reviews within a utilization management setting. The role supports Medicare requirements and internal teams by applying clinical policies...Remote workContract workTemporary workMonday to FridayWeekend work- ...PRN Clinical Pharmacist Coordinate and help manage clinical programs and initiatives, including but not limited... ...(MTM), Annual Wellness Visits, Remote Patient Monitoring, Chronic Care Management... ...and to improve clinical outcomes • Utilize the Joint Commission of Pharmacy...Remote workReliefWork at officeWeekend workAfternoon shift
- ...Location: Florida - Remote WHY JOIN FCS At Florida... ...0 locations in our network. Utilizing innovative clinical research... ...The Clinical Oncology Pharmacist will serve as a member of the... ...medication monitoring, protocol management, medication information, education...Remote workPrivate practiceWork at officeLocal areaWork from home
$52 - $72 per hour
...Job Description Job Description A remote pharmacist role is available on a temporary-to-permanent basis, supporting Medicare Part... ...the opportunity to apply your clinical expertise in utilization management within an evolving, fast-paced environment. Location:...Remote workPermanent employmentContract workTemporary workMonday to FridayWeekend work- ...Clinical Pharmacist OncoHealth is a leading digital health company... ...products and services. This is a remote opportunity with a designated... ...clinical oncology setting, managed care, or relevant educational... ...the use of OncoHealth's utilization management system, OneUM, our...Remote workLocal area
- ...of the nation's leading pharmacy care management companies that specializes in caring for... ...The CareKinesis Clinical Initiatives Pharmacist utilizes clinical knowledge and skills coupled... ...other client engagements. This is a remote position. AnewHealth offers a...Remote workFull timeTemporary workLocal areaFlexible hours
- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the CST zone, ensuring safe, appropriate care and timely approvals. You will review clinical documents, collaborate...Remote workWork from home
- ...Iowa. Why Right Dose Pharmacy? We're reimagining medication management and transforming care. Our core focus is delivering... ...PDPs) and Third-Party Insurances) Develop proficiency in the utilization of pharmacy information systems to meet operational needs and...Remote workFull timeTemporary workWork at officeWork from homeMonday to FridayFlexible hoursShift work
$52 - $72 per hour
...Job Description Job Description A remote pharmacist role is available on a contract-to-hire basis, focusing on Part B drug and... ...reviews. This position requires applying clinical policies, utilization management criteria, and Medicare requirements to make authorization...Remote workContract workMonday to FridayWeekend work$52 - $72 per hour
...This opportunity offers a dynamic role for a licensed pharmacist specializing in utilization management within a fast-paced, evolving environment. The... ...clinical accuracy and process improvement. Location: Remote Schedule: Monday–Friday, 12:00 PM–8:30 PM EST Weekend...Remote workContract workTemporary workMonday to FridayWeekend work- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
- ...and its talent-first flexible/remote work approach, see below and... ...About the Role: As Lead Pharmacist D&F, you'll lead, motivate,... ...the ordering, handling, and management of prescriptions and/or prescription... ...duties such as drug utilization reviews, medication label checks...Remote workLocal areaFlexible hoursNight shift
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