Humana

About Humana

 

Job Category:

Member Quality & Financials - Utilization Management

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full Time

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WAH Staff Utilization Management Pharmacist - Variable Staffing Pool

Humana - Work At Home, Kentucky

Posted: 11/11/2018

Description

The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Staff Utilization Management Pharmacist 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. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

               

Required Qualifications

  • Bachelor's degree
  • 5+ years of technical experience
  • Must have an active license with the Board of Pharmacy in the appropriate state.
  • Pharmacy degree from an accredited college of pharmacy.
  • Ability to participate in Federal prescription programs.
  • 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.
  • Excellent communication skills.
  • Proficient with computers.
  • Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10 panel drug test.
  • Ability to work either Monday thru Friday (8H shifts); 2:30pm - 11:00pm EST or Tuesday thru Friday (10H) shifts; 12:30pm - 11:00pm EST with an every 3rd or 4th Saturday rotation. 

Preferred Qualifications

  • 3+ years' experience in a high volume community or mail order pharmacy practice environment.

Additional Information

Scheduled Weekly Hours

40

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