Clinical Monitoring, Clinical Support, Medications, Microsoft Office, Pharmacy, Utilization Management
Duties: Utilization management pharmacists are responsible for reviewing each plans policy to determine if coverage can be granted for a medication. Provide clinical support and oversight for all utilization management (UM) activities. Responsible for finalizing all denials of clinical prior authorization requests. Education: Licensed Pharmacist required Bachelors Degree in Pharmacy required; PharmD preferred Proficient technical skills utilizing Microsoft Office applications required Utilization Management Experience Preferred, but not required Experience with Specialty Pharmacy/Pharmaceuticals preferred 2+ years lead/supervisor or retail pharmacy experience preferred 3 Non-Negotiable Skills: - Utilization Management Experience (recent experience) - Strong clinical knowledge - Able to make decisions Certifications & Licenses: Licensed Pharmacist Skills: . Supports the Coverage Review Department (CRD) as a clinical resource for drug therapy questions Applies critical thinking to achieve proper clinical decisions when performing clinical reviews Utilizes multiple systems and other clinical resources to achieve proper decisions in Utilization Management reviews Works and maneuvers within a queue system that prioritizes clinical reviews Makes clinical decisions quickly and at times decides and acts with limited information Works and collaborates with a multi-disciplinary clinical team to provide a customer centric experience Conducts accurate review of chart notes and applies critical thinking to achieve proper clinical decisions City: St Louis Schedule: Start Date: 02/23/2026 End Date: 07/31/2026 Schedule Notes: Monday - Friday 9am - 5:30pm EST including every 4th Saturday (day off during the week when working Saturday) Training Schedule will be the same 100% Remote Hours Per Week: 40.00 Hours Per Day: 8.00 Days Per Week: 5.00I
Integrated Resources, Inc