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Humana

Utilization Management Clinical Pharmacist 2 (Contract)

Reposted 2 Days Ago
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Remote
Hiring Remotely in United States
104K-143K Annually
Mid level
Remote
Hiring Remotely in United States
104K-143K Annually
Mid level
The Utilization Management Clinical Pharmacist 2 reviews medication authorizations, advises on cost-effective utilization, and ensures quality patient outcomes by analyzing care plans and usage patterns.
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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.


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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

  • 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 Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

1

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


 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident.

Application Deadline: 07-02-2026
About us
 
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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