Pharmacist Staff/ Pharmacy

Utilization Management Pharmacist

Utilization management pharmacists are responsible for reviewing each plans policy to determine if coverage can be granted for a medication. Provide clinical support and oversight for all utilization management (UM) activities. Responsible for finalizing all denials of clinical prior authorization requests.

Skills: Supports the Coverage Review Department (CRD) as a clinical resource for drug therapy questions Applies critical thinking to achieve proper clinical decisions when performing clinical reviews Utilizes multiple systems and other clinical resources to achieve proper decisions in Utilization Management reviews Works and maneuvers within a queue system that prioritizes clinical reviews Makes clinical decisions quickly and at times decides and acts with limited information Works and collaborates with a multi-disciplinary clinical team to provide a customer centric experience

3 Non-Negotiable Skills: Utilization Management Experience Preferred Strong clinical knowledge Able to make decision

Education: Licensed Pharmacist required Bachelor's Degree in Pharmacy required; PharmD preferred Proficient technical skills utilizing Microsoft Office applications required Utilization Management Experience Preferred, but not required Experience with Specialty Pharmacy/Pharmaceuticals preferred 2+ years lead/supervisor or retail pharmacy experience preferred

EEO: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."