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Full Time Utilization Management Pharmacist Jobs

Acadia Healthcare

Utilization Specialist

Brooksville, FL · On-site

$20 - $23/hr

We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ... Act as liaison between managed care organizations and the facility professional clinical staff.

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Full Time Utilization Management Pharmacist information

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$18

$58

$86

How much do full time utilization management pharmacist jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for full time utilization management pharmacist in the United States is $58.10, according to ZipRecruiter salary data. Most workers in this role earn between $46.63 and $68.75 per hour, depending on experience, location, and employer.

What are some common challenges faced by Full Time Utilization Management Pharmacists, and how can they be addressed?

Full Time Utilization Management Pharmacists often encounter challenges such as balancing clinical guidelines with insurance policy requirements, managing high volumes of prior authorization requests, and communicating effectively with healthcare providers. Staying updated on formulary changes and payer criteria is essential. Building strong relationships with providers and utilizing technology to streamline workflows can help mitigate these challenges and ensure patients receive appropriate and timely care.

What are the key skills and qualifications needed to thrive as a Full Time Utilization Management Pharmacist, and why are they important?

To thrive as a Full Time Utilization Management Pharmacist, you need a Doctor of Pharmacy (PharmD) degree, state licensure, and strong knowledge of drug therapies, formulary management, and clinical guidelines. Expertise with pharmacy benefit management (PBM) systems, electronic health records (EHRs), and prior authorization platforms is typically required. Exceptional communication, analytical thinking, and attention to detail are crucial for collaborating with healthcare providers and ensuring optimal patient outcomes. These competencies enable pharmacists to effectively evaluate medication use, promote cost-effective care, and uphold regulatory standards in managed care environments.

What is the difference between Full Time Utilization Management Pharmacist vs Utilization Review Pharmacist?

AspectFull Time Utilization Management PharmacistUtilization Review Pharmacist
CredentialsPharmacy Degree, Licensure, Certification in Utilization ManagementPharmacy Degree, Licensure, Certification in Utilization Review
Work EnvironmentHealthcare organizations, insurance companies, managed care settingsInsurance companies, healthcare providers, managed care organizations
Job FocusManaging medication utilization, reviewing prior authorizations, ensuring appropriate drug useAssessing medical necessity, reviewing patient cases, approving or denying coverage
Industry UsageCommon in managed care and insurance sectorsCommon in insurance and healthcare provider settings

The Full Time Utilization Management Pharmacist primarily focuses on medication management and prior authorization processes within healthcare organizations. In contrast, the Utilization Review Pharmacist concentrates on evaluating medical necessity and approving coverage for treatments. Both roles require similar credentials but differ in their specific responsibilities and work environments.

What are Full Time Utilization Management Pharmacists?

Full Time Utilization Management Pharmacists are licensed pharmacists who work primarily to evaluate and manage the appropriate use of medications within healthcare systems, often for insurance companies or pharmacy benefit managers. Their role includes reviewing medication requests, ensuring prescriptions meet evidence-based guidelines, and collaborating with healthcare providers to optimize patient outcomes while controlling costs. They work standard full-time hours and focus on clinical decision-making, policy development, and utilization reviews rather than dispensing medications.
What cities are hiring for Full Time Utilization Management Pharmacist jobs? Cities with the most Full Time Utilization Management Pharmacist job openings:
What are the most commonly searched types of Utilization Management Pharmacist jobs? The most popular types of Utilization Management Pharmacist jobs are:
What states have the most Full Time Utilization Management Pharmacist jobs? States with the most job openings for Full Time Utilization Management Pharmacist jobs include:
Full Time Utilization Management Pharmacist jobs near you
RN, Utilization Management | Utilization Management

RN, Utilization Management | Utilization Management

UF Health

The Villages, FL • On-site

Full-time

Posted 5 days ago

Key responsibilities

  • Evaluates patient medical records to ensure the necessity and appropriateness of healthcare services.

  • Coordinates with healthcare providers to ensure compliance with utilization management guidelines and support timely discharge planning.

  • Analyzes utilization data to identify trends and opportunities to improve care coordination.

Job description

Overview
Join an onsite clinical team focused on ensuring the right care at the right time for every patient.
Work Style: Onsite
Location: The Villages, FL
FTE: Full-Time (1.0 FTE)
Schedule: Monday - Friday (occasional weekends required)
Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services in alignment with utilization management guidelines. Collaborates with healthcare providers to support compliance, optimize treatment plans, and promote efficient resource utilization.
Communicates authorization decisions clearly and monitors patient progress to support timely discharge planning. Analyzes utilization data to identify trends and opportunities for process improvement.
Partners with interdisciplinary teams to enhance care coordination, ensure accurate documentation, and maintain compliance with regulatory and organizational standards.
Responsibilities
Key Responsibilities
  • Evaluates patient medical records to ensure the necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers to ensure compliance with utilization management guidelines.
  • Supports the optimization of treatment plans to promote effective patient care and appropriate resource utilization.
  • Communicates authorization decisions clearly and supports timely discharge planning.
  • Analyzes utilization data to identify trends and opportunities to improve care coordination.
  • Collaborates with interdisciplinary teams to ensure accurate documentation and regulatory compliance.

Qualifications
Education & Experience:
Registered Nurse (RN) with a current Florida license required.
  • Three (3) years of critical care nursing experience, or
  • Five (5) years of medical-surgical nursing experience, or
  • Three (3) years of utilization review, case management, or third-party payer experience.

Qualifications
  • Active Registered Nurse (RN) license with 3+ years of experience in utilization review or case management.
  • Strong knowledge of healthcare utilization management guidelines and regulatory compliance.
  • Experience evaluating medical necessity and optimizing treatment plans.
  • Excellent communication skills with the ability to clearly convey authorization decisions.
  • Ability to analyze utilization data and support effective care coordination.
  • Strong organizational skills with the ability to manage multiple priorities simultaneously.
  • Ability to work independently and collaboratively with multidisciplinary teams.
  • Strong attention to detail and innovative problem-solving skills.
  • Flexibility to adjust work hours and days based on departmental needs.

Motor Vehicle Operator Designation:
Employees in this position will not operate vehicles for an assigned business purpose.
Note: Please indicate the appropriate operator designation on the Request for Personnel (RFP) form at the time of submission.
Licensure/Certification/Registration:
  • Registered Nurse (RN) with a current Florida license required.

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