[Hiring] Utilization Management Clinical Pharmacist 2 @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.
• Understands department, segment, and organizational strategy and operating objectives.
• Makes decisions regarding own work methods, occasionally in ambiguous situations.
• Follows established guidelines/procedures.

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

Requirements

• Managed care experience - specifically Utilization management review

Benefits

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

Schedule

• Able to work 8 or 10 hour shifts Monday thru Friday between the hours of 9:30 AM and 11 PM ET
• Some weekend coverage may be required
• Mandatory overtime during peak season
• Occasional travel to Humana's offices for training or meetings may be required

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

Application Deadline

07-02-2026

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.