Clinical Pharmacist, Utilization Management

Rightway
Irving, TX
Category Healthcare
Job Description
We are seeking a Clinical Pharmacist, Utilization Management to join our PBM Clinical Operations team. The role will assist UM leadership in delivering on our UM strategy and actively work UM cases. The ideal candidate will have a pharmacy degree, 1-3+ years of managed care experience, and be willing to achieve and maintain licensure in multiple states.

Requirements

  • Support all lines of business via reviewing utilization management requests for coverage that are clinically appropriate and cost effective
  • Continual review of UM operational processes to ensure effective and compliant delivery of PBM services to our clients
  • Coordinate with Pharmacy technicians, Pharmacists, and/or Medical Directors on UM activities
  • Participate in the quality review and inter-rater reliability processes
  • Supports P&T process including the development of therapeutic class/drug monographs as needed
  • Research and develop therapy-specific clinical policies and utilization management programs

Benefits

  • Free onsite parking and round-the-clock security team
  • Free onsite fitness center and outdoor garden space for breaks
  • Fully stocked kitchen with coffee, snacks, and beverages
  • Discounted onsite café with a refreshed menu
  • Modern, light-filled workspace with collaborative and quiet areas
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