Clinical Pharmacist, Utilization Management - Remote

Overview

The Clinical Pharmacist, Utilization Management role is part of the Rightway PBM Clinical Operations team. This position focuses on assisting in the delivery of utilization management strategies and ensuring cost-effective drug coverage for clients.

In Short

• Support utilization management requests for clinically appropriate coverage.
• Review and improve UM operational processes.
• Coordinate with pharmacy staff on UM activities.
• Ensure compliance with State and Federal guidelines.
• Discuss clinical strategies with prescribers as needed.
• Participate in quality review processes.
• Support the development of clinical policies and programs.
• Collaborate with Clinical Operations leadership.

Requirements

• Pharmacy Degree required, PharmD preferred.
• 1-3+ years of managed care experience preferred.
• Pharmacist license in good standing.
• Available for 40 hours/week, including potential evening/weekend shifts.
• Detail-oriented with strong problem-solving skills.
• Effective communication and leadership abilities.

Benefits

• Opportunity to impact healthcare affordability.
• Work in a mission-driven organization.
• Collaborative team environment.
• Potential for professional growth.