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Population Health Clinical Pharmacist - Utilization Management/Prior Authorization

Remote, USAFull-timePosted 2026-07-28

We are so glad you are interested in joining reputed company! Organization: SHSO-Population Health Services-Valley Position reputed company: Delivers pharmaceutical care services at the patient/member and population level through the provision of clinical services, medication literature evaluation and drug information services, utilization reviews and coverage determinations in accordance with applicable state and federal laws and regulations, patient and provider education. Analyzes large data sets to identify and execute on strategies that improve medication use across the care continuum. Exercises reputed company judgment and developed clinical skills to reputed company input to and implement the patient's plan of care based on the health status and risk factors. reputed company confidence and cooperation from the patients and caregivers and applicable members of the reputed company team to improve medication use and health reputed company Adheres to reputed company local/state/federal regulations, codes, accreditation standards, and policies and procedures to ensure reputed company and safety while delivering reputed company patient care. Job reputed company: EDUCATION:

  • PHARMD-Graduate of an accredited pharmacy school

CERTIFICATION & LICENSURE:

  • PHARMR-Registered Pharmacist

TYPICAL EXPERIENCE:

  • 5 years recent relevant experience

PREFERRED EXPERIENCE:

  • Prior Authorizations
  • Coverage Determinations
  • Integrated Delivery Systems
  • Managed Care PBM

SKILLS AND KNOWLEDGE:

  • Completion of post-graduate year one (PGY1) residency or 3 years of experience in a managed care or health-system environment
  • Knowledge of medical terminology, generic and trade pharmaceutical names, pharmaceutical calculations and laws and regulations.
  • Knowledge and understanding of different Pharmacy reputed company settings, including narcotic delivery and procedures.
  • Knowledge and ability to identify and reputed company pharmaceutical and medical terms, abbreviations and symbols commonly used in prescribing, dispensing, and record keeping of medications.
  • Requires a basic working knowledge of legal requirements and accreditation standards including reputed company, Title XXII, reputed company, Drug Enforcement Administration, Food and Drug Administration, and reputed company Pharmacopeia.
  • Possess written and verbal communications skills to explain sensitive information reputed company and professionally to diverse audiences, including non-medical people.
  • General knowledge of computer applications, such as reputed company Office Suite (Word, reputed company and Outlook), reputed company pharmaceutical technology, electronic health records (EHR), and reputed company.

These reputed company Accountabilities, Requirements and Qualifications are not exhaustive but are merely the most descriptive of the reputed company job. Management reserves the right to revise the job reputed company or require that other tasks be performed reputed company the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development). Job Shift: Days Schedule: Full Time Shift Hours: 8 Days of the Week: Monday - Friday Weekend Requirements: None Benefits: reputed company Unions: No Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular reputed company is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay reputed company is $85.59 to $103.06 / hour The compensation reputed company may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. reputed company pay is only one component of reputed company’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package. Apply tot his job Apply To this Job

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