Humana Logo

Humana

Utilization Management Clinical Pharmacist 2 (Contract)

Reposted Yesterday
Be an Early Applicant
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.
The summary above was generated by AI
Become a part of our caring community
 
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.


Use your skills to make an impact
 

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.

Similar Jobs

An Hour Ago
Remote or Hybrid
United States
146K-220K Annually
Senior level
146K-220K Annually
Senior level
Artificial Intelligence • Big Data • Cloud • Information Technology • Software • Big Data Analytics • Automation
Design, build, and ship production-grade agentic AI systems that connect code context with runtime observability. Implement end-to-end LLM systems (prompting, tool calling, retrieval, memory, agents), define evaluation metrics and datasets, integrate with development workflows and Dynatrace, set technical strategy, mentor engineers, and own monitored production systems.
Top Skills: Agentic Ai/AgentsAWSDynatraceGoGCPIdesLarge Language Models (Llms)Memory ManagementAzurePromptingPythonRetrieval (Rag)Static AnalysisTool Calling
An Hour Ago
Easy Apply
In-Office or Remote
Easy Apply
Senior level
Senior level
Cloud • Information Technology • Security • Software
Lead the development of JumpCloud's AI platform, focusing on architecture, AI model integration, and mentoring engineers while ensuring operational excellence and customer satisfaction.
Top Skills: AIAPIsAWSAzureCi/CdCloud PlatformsGCPInfrastructure As CodeMachine LearningObservability ToolsPlatform Engineering
An Hour Ago
Easy Apply
Remote or Hybrid
USA
Easy Apply
60K-65K Annually
Junior
60K-65K Annually
Junior
Fintech • Real Estate • Software • Financial Services • PropTech
Manage the full lifecycle of escrow transactions: order title searches and payoff demands, clear title requirements, coordinate with external title companies and notaries, review closing documents for accuracy, and support escrow officers with file balancing and ledger management while communicating proactively with clients.
Top Skills: Google SuitesMS OfficeQualia

What you need to know about the Seattle Tech Scene

Home to tech titans like Microsoft and Amazon, Seattle punches far above its weight in innovation. But its surrounding mountains, sprinkled with world-famous hiking trails and climbing routes, make the city a destination for outdoorsy types as well. Established as a logging town before shifting to shipbuilding and logistics, the Emerald City is now known for its contributions to aerospace, software, biotech and cloud computing. And its status as a thriving tech ecosystem is attracting out-of-town companies looking to establish new tech and engineering hubs.

Key Facts About Seattle Tech

  • Number of Tech Workers: 287,000; 13% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Amazon, Microsoft, Meta, Google
  • Key Industries: Artificial intelligence, cloud computing, software, biotechnology, game development
  • Funding Landscape: $3.1 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Madrona, Fuse, Tola, Maveron
  • Research Centers and Universities: University of Washington, Seattle University, Seattle Pacific University, Allen Institute for Brain Science, Bill & Melinda Gates Foundation, Seattle Children’s Research Institute

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account