Utilization Management Clinical Pharmacist 2

Humana

Clinical Pharmacist responsible for medication reviews and patient advisement. Part-time remote position for a healthcare company with flexible hours and variable staffing.

Posted 5/28/2026part-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $104,000 - $143,000 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

medical necessity reviewsmedication reviewsmedication care plan analysisutilization investigationcost effective utilizationquality patient outcomesproblem solvingmanaged care experienceutilization management review

Soft Skills

self-directedcollaborative problem solvingstrong communication skillsfocused work ethicaccurate work ethichighly productive work ethic

Tools & Technologies

various computer systems

Certifications & Qualifications

active license with the Board of PharmacyBachelor's degreePharm.DPharmacy degree from an accredited college

Industry Keywords

Federal prescription programsMedicare reviewsMedicaid reviews

About the role

Key responsibilities & impact

complete medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization
work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action
complete a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns
intervene and advise patients and providers to promote cost effective utilization and quality patient outcomes, as needed
understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas
make decisions regarding own work methods, occasionally in ambiguous situations
follow established guidelines/procedures

Requirements

What you’ll need

Bachelor's degree/Pharm.D
Must have an active license with the Board of Pharmacy in the state of residence
Pharmacy degree from an accredited college of pharmacy
Ability to participate in Federal prescription programs (Medicare/Medicaid reviews)
Self-directed, but also able to work well in a group
Ability to solve problems and encourage others in collaborative problem solving
Work ethic that is focused, accurate, and highly productive
Strong communication skills
Proficient with computers -- various systems: add examples
Managed care experience - specifically Utilization management review

Benefits

Comp & perks

paid time off
401(k) retirement savings plan
employee assistance program
business travel and accident