Lead Utilization Management Pharmacist
Judi Health · United States · US
Utilization Review
Remote
physician
Pharmacist
Demand85
Career growth72
Healthcare fit84
Remote potential90
Salary band
USD 134k – 146k
5-year outlook
Lead utilization management pharmacist roles typically remain competitively compensated within managed care, PBM, and health plan pharmacy operations, though exact pay is not stated. Growth can lead toward utilization management leadership, clinical operations, pharmacy benefits, or quality/compliance roles.
Clinical license
Required
Applicant reach
moderate
Seniority
lead
Employment type
full-time
Date found
2026-10-26
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- physician, Pharmacist
- Rate period
- Annual
Why this was classified this way
- contract
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying for licensed pharmacists with prior authorization, utilization management, or call center experience who want a remote, non-bedside pharmacy operations role. Less suitable for pharmacists without managed care/prior auth exposure or those seeking direct patient care.
Who should apply
Licensed pharmacists with managed care, PBM, prior authorization, appeals, or utilization review experience; clinical pharmacists comfortable with high-volume call center metrics; pharmacists seeking remote leadership-track roles in pharmacy operations.
CV angle
Frame real pharmacy experience around prior authorization and appeal reviews, medical necessity and contract criteria, drug literature evaluation, provider/member communication, pharmacy claims review, compliance, quality improvement, queue management, and any team training or workflow leadership. Emphasize active pharmacist licensure and measurable call center or case-review productivity without inventing managed care experience.
Skills to highlight
- Prior authorization and appeals review
- Utilization management and medical necessity criteria
- Clinical pharmacy decision-making
- Pharmacy claims data review
- Provider and member communication
- Call center and queue management
- Quality improvement and compliance
- Team training and clinical operations leadership
Role summary
A lead pharmacist role overseeing daily utilization management functions such as prior authorization and appeal reviews, override requests, provider/member education calls, queue management, compliance, quality improvement, and support for utilization management pharmacists in a remote, metric-driven environment.
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