Clinical Pharmacist - Managed Care (Remote)

Pharmacy Careers

Remote job

Remote Drug Utilization Review Pharmacist Safe & Cost-Effective Medication Use

Work from home analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical analysis and want to improve outcomes at scale. Key responsibilities include conducting prospective, concurrent, and retrospective drug utilization reviews, evaluating prescribing patterns against clinical guidelines and formulary criteria, identifying potential drug interactions, therapeutic duplications, and inappropriate therapy, preparing recommendations for prescribers to optimize therapy and reduce risk, documenting reviews and ensuring compliance with state, federal, and health-plan requirements, and contributing to quality-improvement initiatives and pharmacy program development.

PharmD or Bachelor of Pharmacy, licensure: active U.S. pharmacist license, experience: managed care, PBM, or health-plan preferred. Hospital and community pharmacists with strong clinical skills are encouraged to apply. Shape prescribing decisions that affect thousands of patients, build expertise in managed care and population-health pharmacy, many DUR roles offer hybrid or fully remote schedules, competitive salary, benefits, and career advancement.

About us we are a confidential healthcare partner providing managed-care pharmacy services nationwide. Apply today advance your career in managed care apply now for our remote drug utilization review pharmacist opening.

Pharmacy Careers

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Clinical Pharmacist - Managed Care (Remote) in Wichita, KS vacancy

Clinical Pharmacist - Managed Care (Remote)
...Remote DUR Pharmacist – Safe & Cost-Effective Medication UseWork From Home Analyze medication use patterns, apply clinical guidelines... ...collaborate with providers — all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical...
Remote work
Pharmacy Careers
Warwick, RI
3 days ago
Clinical Pharmacy Reviewer (Pharmacist) - Remote
...The Clinical Pharmacy Reviewer (Pharmacist) evaluates complex prior authorization... ...role interprets complex drug criteria, formulary... ...medications. Through rigorous Drug Utilization Review (DUR) and objective decision-... ...? Collaborative remote culture Professional...
Remote work
Local area
Work from home
Dane Street
United States
3 days ago
Pharmacist - Pharmacy, Full Time
$113.7k - $162.4k
.... Summary As a Preferred Drug List (PDL) Pharmacist supporting the Gainwell Pricing... ...criteria, support therapeutic class reviews, analyze net cost and utilization trends, and collaborate across... ...role This position is remote. Work hours: Eastern Time Zone...
Remote work
Full time
Flexible hours
Gainwell Technologies LLC
Ohio
5 days ago
PRN Pharmacist Reviewer - Medicare Part D Formulary Criteria Review
...Solutions is seeking PRN pharmacists to support our... ...Medicaid Services (CMS) reviewing the prior authorization... ...Medicare Prescription Drug Benefit Manual, FDA-approved... ...D requirements and utilization management principles,... ...: US-based fully remote/work-from-home position...
Remote work
Contract work
Temporary work
Relief
Seasonal work
Work at office
Work from home
Rainmakers Strategic Solutions
Remote
20 days ago
Lead Utilization Management Pharmacist
$134k - $146k
...Position Summary: The Lead Utilization Management Pharmacist will oversee and manage the... ...to prior authorization reviews, override requests, member/... ..., secondary, and tertiary drug resources to support decision... ..., stay productive in a remote, high-volume, metric driven...
Remote work
Full time
Contract work
Local area
Flexible hours
Shift work
Weekend work
Judi Health
Remote
20 days ago
Remote Clinical Review Pharmacist
...Remote Clinical Review Pharmacist – Work From HomeLeverage your clinical knowledge in a fully remote Clinical Review Pharmacist role. Evaluate prescriptions... ...determinations.Collaborate with physicians, nurses, and utilization-management teams on complex cases.Document...
Remote work
Work from home
Flexible hours
Pharmacy Careers
South Jordan, UT
2 days ago
Remote Formulary Pharmacist - P&T & DUR
...Centene Corp. is seeking a remote Pharmacy Formulary Specialist to define and... .... The role emphasizes evaluating drug use trends, literature reviews, and cost-of-care analyses, with flexible... ...and a current, unrestricted pharmacist license, with 3+ years in managed care...
Remote work
Flexible hours
Centene Corporation
United States
22 hours ago
Remote Pharmacovigilance / Drug Safety Pharmacist
...Remote Pharmacovigilance Pharmacist – Drug Safety From HomeContribute to global patient safety by collecting, evaluating, and documenting adverse events... ...and investigational products.Conduct literature reviews and support safety signal detection activities.Prepare...
Remote work
Work from home
Flexible hours
Pharmacy Careers
Omaha, NE
1 day ago
Remote RN Medical Reviewer II (Claims & Utilization)
...BlueCross BlueShield of South Carolina is seeking a Remote RN Medical Reviewer II to perform medical reviews using clinical documentation and... ...documentation, determine medical necessity, and support claims and utilization practices in a work-from-home setup. The role requires...
Remote work
Work from home
Southcarolinablues
United States
1 day ago
Utilization Review Specialist
$60k - $62k
...Job Description Remote- Work From Home, Jackson, Jackson, Michigan, United States... ...expertise. Position Overview The Utilization Review Specialist is responsible for all aspects... ...Confidentiality Laws. Knowledge of Drug-Free Workplace Policies. Knowledge of Corporate...
Remote work
Full time
Part time
Work from home
Flexible hours
Coronis Health
Jackson, MI
1 day ago
Remote Prior Authorization Pharmacist
...Elevance Health is seeking a Prior Authorization Clinical Pharmacist to evaluate and manage pharmaceutical use, supporting Drug Utilization Review (DUR), Drug Information Services (DIS), and formulary management. This full-time, virtual role requires a BA/BS in Pharmacy...
Remote work
Full time
Elevance Health
Durham, NC
4 days ago
Staff Utilization Management Clinical Pharmacist (VSP/PT)
$104k - $143k
...part of our caring community The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a clinical pharmacist... ...necessity and comprehensive medication reviews for prescriptions requiring pre-... ...action. Job Description Location: Remote – United States Schedule: This...
Remote work
Bi-weekly pay
Daily paid
Full time
Part time
Apprenticeship
Work at office
Work from home
Home office
Shift work
Weekend work
Afternoon shift
Humana
Remote
14 days ago
Remote Staff Pharmacist New
...Opportunity: As a BlinkRx Pharmacist, you are the clinical... ...Verification and Dispensing Review and clinically verify new... ...appropriateness, drug-drug interactions, contraindications... ...daily prospective drug utilization review (DUR) to identify and resolve clinical...
Remote work
Full time
Immediate start
Rotating shift
Blink Health
United States
23 hours ago
Pharmacist (Specialty)
$107.7k - $199.28k
...and clinical monitoring activities. Key Details : Remote Pharmacist (Specialty). Must be a licensed Pharmacist in Texas, Florida... ...include pharmacist verification of prescriptions, Drug Utilization Review (DUR), patient counseling, developing care plans, following...
Remote work
Hourly pay
Full time
Part time
Work at office
Monday to Friday
Flexible hours
Centene Corporation
Florida
7 days ago
Clinical Pharmacy - Utilization Management Clinical Pharmacist PC #146-2000
...The Utilization Management Clinical Pharmacist is responsible for playing a critical role in... ...based, and cost-conscious drug therapy while supporting... ...RESPONSIBILITIES: Review prior authorization requests... .... Ability to work remotely will be provided to...
Remote work
Full time
Work at office
Weekend work
CommunityCare
Remote
4 days ago
Compounding Pharmacist (Days)
...talent-first flexible/remote work approach, see below... ...the Head Compounding Pharmacist, the Compounding... ...compounding personnel Review and approve materials... ...Pharmacy and the Food and Drug Administration (FDA)... ...pharmacist duties such as drug utilization reviews, patient...
Remote work
Currently hiring
Local area
Flexible hours
Shift work
Day shift
hims & hers
Amanda, OH
10 days ago
Ambulatory Care Pharmacist - Oncology - Full Time
$168.79k - $281.3k
...patients. The Senior Pharmacist acts as an integral member... ...direct patient care, drug dispensing, research &... ...Lake Union location and remotely. This position may... ...comprehensive medication therapy review and other activities as... ...status. Utilize tools in educating the...
Remote work
Full time
Temporary work
H1b
Visa sponsorship
Relocation package
Monday to Friday
Flexible hours
Fred Hutchinson Cancer Research Center
Seattle, WA
2 days ago
Registered Pharmacist
$22k
...talent-first flexible/remote work approach, see below... ...the Head Compounding Pharmacist, the Compounding... ...compounding personnel Review and approve materials... ...Pharmacy and the Food and Drug Administration (FDA)... ...pharmacist duties such as drug utilization reviews, patient...
Remote work
Currently hiring
Local area
Relocation package
Flexible hours
Shift work
Day shift
hims & hers
Canal Winchester, OH
7 days ago
Remote Staff Pharmacist
...Opportunity: As a BlinkRx Pharmacist, you are the clinical... ...Verification and Dispensing Review and clinically verify new... ...appropriateness, drug-drug interactions, contraindications... ...daily prospective drug utilization review (DUR) to identify and resolve clinical...
Remote work
Full time
Immediate start
Rotating shift
Blink Health
Remote
6 days ago
Remote Pharmacy Utilization & PA Specialist
...Point32Health, Inc. is seeking a Pharmacy Utilization Management (UM) Specialist to set up... ...multiple channels and ensure timely reviews by pharmacists or medical directors. A strong background... ...is essential. The role supports remote work and requires attention to detail,...
Remote work
Point32Health, Inc.
United States
3 days ago
Lead Utilization Management Pharmacist (Fully Remote)
...Lead Utilization Management Pharmacist overseeing daily clinical pharmacy functions. Ensure efficient... ...: Perform prior authorization reviews, appeal reviews, and override requests... ...Ability to work independently in a remote, metric-driven environment. Work...
Remote work
Shift work
Weekend work
Judi Health, LLC
United States
2 days ago
Associate Clinical Pharmacist - Pharmacy Analytics
...Associate Clinical Pharmacist – Pharmacy AnalyticsFull... ...criteria, performing drug utilization analyses, evaluating digital... ...days (Monday, Friday) remote option.... ...clinical programs such as DUR and formulary/non-formulary... ...present therapeutic class reviews and drug monograph...
Remote work
Permanent employment
Work experience placement
Internship
H1b
Work at office
Monday to Friday
Wellmark
Des Moines, IA
22 hours ago
PBM Utilization Management Pharmacist (REMOTE)
...because we are clinicians! Position Summary: The Utilization Management Pharmacist plays a vital role in promoting safe, effective, and appropriate... ...medication use. This position is responsible for reviewing prior authorization requests, supporting clinical programs...
Remote work
Permanent employment
Contract work
Local area
Weekend work
Unitas Corporation
United States
2 days ago
Remote Utilization Management Pharmacist Prior Auth Expert
...Judi Health in the United States is seeking a Utilization Management Pharmacist to review prior authorizations and support clinical programs. This role combines clinical decision-making with service excellence in a fast-paced, collaborative environment. You will assess...
Remote work
Capital Rx
New York, NY
1 day ago
Remote Pharmacy Utilization Specialist - Prior Authorization
...Point32Health is seeking a Pharmacy Utilization Management Specialist to set up and process prior... ...across multiple applications. You will review cases for regulatory and accreditation requirements and document notes for pharmacist or medical director review. In this...
Remote work
Point32Health
United States
1 day ago
RN Care Management(Remote)
...Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews for prior approvals, benefit inquiries, and inpatient/outpatient services. This role requires interpreting evidence-based criteria, guidelines, and policies...
Remote work
Work from home
Arkansas Blue Cross
United States
3 days ago
Remote Lead Utilization Pharmacist - Prior Authorization
...Judi Health, LLC is seeking a Lead Utilization Management Pharmacist to oversee daily clinical pharmacy functions... ..., including prior authorization reviews and education for members and... ...Pharmacy with 2+ years of experience. Remote work from the US with ET shift and weekend...
Remote work
Shift work
Weekend work
Judi Health, LLC
United States
22 hours ago
Remote RN: Clinical Utilization & Discharge Reviewer
...Centene Corporation is seeking a remote Nurse Reviewer to perform concurrent reviews, assess medical necessity, and contribute to discharge... ...candidates will have 2–4 years of acute care experience and knowledge of Medicare/Medicaid utilization management.J-18808-Ljbffr...
Remote work
Weekend work
Centene Corporation
Phoenix, AZ
1 day ago
Remote Medical Reviewer - RN (Claims & Utilization)
...Broadway Ventures is seeking a Medical Reviewer for a remote role handling various claims (Radiology, Ambulance, Physical Therapy, Surgical... ...active RN license in the U.S., an Associate’s degree, and 2+ years in clinical work with utilization/medical review. #J-18808-Ljbffr
Remote work
BROADWAY VENTURES, LLC
United States
1 day ago
Clinical Pharmacist Investigational Drug Services
$62.89 - $92.44 per hour
...Clinical Pharmacist Schedule: Full-time (40 hours/week) Shifts: Monday... ...experience in investigational drug services, clinical research,... ...Healthcare Investigational Review Board, Clinical Trials Executive... .... If applying for a remote or hybrid role, this includes...
Remote work
Hourly pay
Full time
Monday to Friday
Shift work
Intermountain Healthcare
Midvale, UT
22 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Clinical Pharmacist - Managed Care (Remote). Be the first to apply!