Utilization Management Clinical Pharmacist 2 (Contract)

at Humana in Boise, Idaho, United States

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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 Utilization Management Clinical Pharmacist 2 ( VSP /PT) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Utilization Management Clinical Pharmacist 2 ( VSP /PT) completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of 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 and receives guidance where needed. Follows established guidelines/procedures.

Use your skills to make an impact

Required Qualifications

+ Bachelors 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

+ This role is Variable Staffing Pool ( VSP ), Variable Staffing Pool Humana associates work flexible hours to meet business needs, with no guaranteed minimum or maximum number of hours in any week. This role is also eligible for limited benefits.

Schedule

+ Able to work 8 or 10 hour shifts Monday thru Friday between the hours of 930am and 11pm ET

+ Some weekend coverage may be required

+ Mandatory overtime during peak season

Travel: While this is a remote position, occasional travel to Humanas offices for traini