Pharmacist - Utilization Management (UM)-3

About the role

For our client, we are seeking a Pharmacist - Utilization Management (UM)-3 to join the team of a leader in the Finance & Insurance space. This role supports medication coverage decisions by evaluating prior authorization requests and appeals against established medical policy. The pharmacist will research clinical information, apply utilization management standards, and help ensure accurate claims routing and payment. This position also partners with others to uphold compliance, protect confidential customer information, and support quality decision-making in a regulated environment.

Location: Remote - US based candidates only, no visa sponsorship available

Responsibilities

• Evaluate physician requests for prior authorization and appeals against medical policy
• Make coverage determinations using the utilization review system
• Conduct additional research to support medication coverage decisions
• Update system records to ensure proper claims routing and payment
• Perform other duties as assigned

Qualifications

• Bachelor's degree in Pharmacy required; Doctorate preferred
• 1-3 years of experience in Pharmacy required
• Registered Pharmacist license required

Skills

• Strong oral and written communication skills
• Proficient in general computer skills

Pay

Compensation: $102,700 – $164,600 annually

Benefits

• Office-based position with minimal travel requirements
• Opportunity to teach and train others regularly
• Engagement in compliance with ethical and legal standards
• Access to confidential customer information with a focus on data protection