Staff Utilization Management Clinical Pharmacist (VSP/PT) at Humana in Remote Nationwide

Job description

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. Job Description Location: Remote – United States Schedule: This is a VSP (Variable Staffing Pool) role. The hours will vary between 24-40 hours per week. The shift for training will be 10:00AM-6:30PM ET. After training, a mid to later shift (e.g. 8PM ET or later ending time) will be assigned based on business need. Some weekend coverage may be required. Mandatory overtime during peak season. Use your skills to make an impact Additional Job Description Required Qualifications: 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 ​ Interview Format : As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. WAH Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary