[Hiring] Staff Utilization Management Clinical Pharmacist @Humana

Role Description

The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

• Completes a review that includes a full analysis of the medication care plan.
• Investigates overall utilization and identifies unusual usage patterns.
• Intervenes and advises patients and providers to promote cost-effective utilization and quality patient outcomes, as needed.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction.
• Follows established guidelines/procedures.

Qualifications

• Typically requires Bachelor's degree or equivalent.
• Less than 5 years of technical experience.

Requirements

• Work at Home Requirements:
  • Self-provided internet service must meet the following criteria:
    • Minimum download speed of 25 Mbps.
    • Minimum upload speed of 10 Mbps.
  • Wireless, wired cable, or DSL connection is suggested.
  • Humana reserves the right to require associates to upgrade their internet service if necessary.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Paid time off.
• 401(k) retirement savings plan.
• Employee assistance program.
• Business travel and accident insurance.

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.

$104,000 - $143,000 per year