Clinical Pharmacist - Utilization Management

32

Base: $110,594.35 - $165,891.53; bonus/equity: var...
Review prior authorization requests
Ensure regulatory compliance
Consult with medical directors
The Clinical Pharmacist is responsible for reviewing and managing daily caseloads of pharmacy prior authorization requests to ensure timely coverage determinations

Job Summary

  • The Clinical Pharmacist is responsible for reviewing and managing daily caseloads of pharmacy prior authorization requests to ensure timely coverage determinations.
  • Point32Health is a leading not-for-profit organization dedicated to delivering high-quality, affordable healthcare to nearly 2 million members.
  • The role includes communicating with members and providers regarding case status and consulting with Medical Directors on cases that fail criteria.

Matching Summary

The Clinical Pharmacist is responsible for reviewing and managing daily caseloads of pharmacy prior authorization requests to ensure timely coverage determinations.

Salary

Base: $110,594.35 - $165,891.53; Bonus/Equity: Variable pay eligible; Benefits: Comprehensive total rewards including medical, dental, vision, retirement, and paid time off

Skills & Requirements

Must-have

  • Review prior authorization requests
  • Ensure regulatory compliance
  • Consult with medical directors
  • Manage case turnaround times

Nice-to-have

  • Strong communication skills
  • Experience with automated tools
  • Commitment to inclusion
  • Empathetic service approach

Key Requirements

  • Clinical Pharmacist license or equivalent
  • Experience in utilization management
  • Knowledge of regulatory guidelines

Work Rights

Not specified

Tailored Resume

Cover Letter