Staff Utilization Management Pharmacist (VSP/PT)

Staff Utilization Management Pharmacist (VSP/PT)

The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional responsible for conducting comprehensive reviews of medication care plans. This includes evaluating medical necessity, analyzing overall utilization, and identifying unusual usage patterns. The pharmacist may intervene and provide clinical guidance to patients and providers to support cost-effective medication use and promote high-quality patient outcomes.

Required Qualifications

• Bachelor's degree or Doctor of Pharmacy (Pharm.D.) from an accredited college of pharmacy

• Active pharmacist license in the state of residence

• Eligibility to participate in federal prescription programs (e.g., Medicare/Medicaid)

• Self-directed with the ability to work effectively both independently and in a team environment

• Strong problem-solving skills and the ability to foster collaborative solutions

• High attention to detail with a strong work ethic focused on accuracy and productivity

• Excellent verbal and written communication skills

• Proficiency with computer systems, including but not limited to:

  • Microsoft Office Suite (Word, Excel, Outlook)
  • Clinical decision support tools (e.g., Micromedex, Lexicomp)
  • Pharmacy benefit management (PBM) platforms
  • Electronic health records (EHRs)

• Passion for contributing to an organization focused on continuously improving the consumer experience

Preferred Qualifications

• Experience in managed care pharmacy, particularly in utilization management review

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 $94,900 - $130,500 per year

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.

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.