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The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Schedule:

• Able to work 8 hour shifts Monday thru Friday between 10:30am and11:00pm EST OR 10 hour shifts Tuesday thru Friday between 10:30am and 11:00pm EST.

• Every 5th Saturday will be required

• 1 company holiday will be required in 2025

Location: Remote United States

Job Description

The Staff Utilization Management Pharmacist completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns. The Pharmacist intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes as needed.

Use your skills to make an impact
 

Required Qualifications

• 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

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Managed care experience - specifically Utilization management review​

Additional Information:

Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

WAH Requirements:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Statement:

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$94,900 - $130,500 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidia