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Remote Utilization Management Pharmacist Jobs in Kentucky

Pharmacy Claims Processor / Remote

Louisville, KY · Remote

$15.50 - $19.75/hr

... receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy ... Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer ...

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy ... Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer ...

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy ... Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer ...

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy ... Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer ...

... management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and ... Remote work eligibility is subject to all work from home criteria met and based on business need ...

... utilization, and carrier capacity management. * Oversee carrier relationships, transportation ... Plasma, biologics, healthcare, pharmaceutical, life sciences, or cold chain logistics experience.

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Remote Utilization Management Pharmacist information

What is a remote utilization management pharmacist?

A Remote Utilization Management Pharmacist is a licensed pharmacist who works from a non-traditional setting, such as home, to review medication use and ensure that prescribed drugs are medically necessary, cost-effective, and aligned with clinical guidelines. They collaborate with healthcare providers, insurance companies, and patients to optimize medication therapy while controlling costs and preventing unnecessary treatments. Their work often involves evaluating prior authorization requests, reviewing patient medication histories, and providing recommendations for alternative therapies when appropriate.

How does a remote utilization management pharmacist typically collaborate with other healthcare professionals while working offsite?

Remote Utilization Management Pharmacists work closely with physicians, nurses, and case managers primarily through secure digital platforms and regular conference calls. They review medication requests, provide clinical recommendations, and help ensure patients receive appropriate therapies in line with established guidelines. Effective communication and timely documentation are essential, as collaboration often relies on electronic health records and virtual meetings. Building strong professional relationships remotely can be a challenge, but most organizations provide robust digital tools and dedicated support teams to facilitate seamless interaction.

What are the key skills and qualifications needed to thrive as a remote utilization management pharmacist, and why are they important?

To thrive as a Remote Utilization Management Pharmacist, you need a Doctor of Pharmacy (PharmD) degree, active pharmacist licensure, and experience in medication review and clinical decision-making. Familiarity with pharmacy benefit management (PBM) systems, electronic health records (EHRs), and utilization management software is typically required. Strong analytical skills, attention to detail, and effective written communication are vital for evaluating medication requests and collaborating with healthcare providers. These competencies ensure appropriate medication use, regulatory compliance, and optimal patient outcomes in a remote healthcare setting.

What is the difference between Remote Utilization Management Pharmacist vs Remote Pharmacy Benefits Manager?

AspectRemote Utilization Management PharmacistRemote Pharmacy Benefits Manager
CredentialsPharmacy license, certification in utilization reviewPharmacy license, health plan or benefits management experience
Work EnvironmentHealthcare organizations, insurance companies, telehealth platformsHealth insurance companies, pharmacy benefit management firms
Industry UsageFocuses on medication review, prior authorizations, and clinical decision supportOversees pharmacy benefit plans, formulary management, and cost control strategies

While both roles involve pharmacy expertise and work remotely, the Remote Utilization Management Pharmacist primarily reviews medication appropriateness and manages prior authorizations, whereas the Remote Pharmacy Benefits Manager focuses on managing pharmacy benefit plans and formulary strategies. Understanding these distinctions helps professionals choose the role that best aligns with their skills and career goals.

What are popular job titles related to Remote Utilization Management Pharmacist jobs in Kentucky?

For Remote Utilization Management Pharmacist jobs in Kentucky, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management Pharmacist jobs in Kentucky look for?

The top searched job categories for Remote Utilization Management Pharmacist jobs in Kentucky are:

What cities in Kentucky are hiring for Remote Utilization Management Pharmacist jobs?

Cities in Kentucky with the most Remote Utilization Management Pharmacist job openings:

Infographic showing various Remote Utilization Management Pharmacist job openings in Kentucky as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 4% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Remote Clinical Pharmacist Specialist - Neurology and Psychology

Baptist Health

Louisville, KY • Remote

$113K - $135K/yr

Full-time

Re-posted 25 days ago


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Job description

Summary

System Clinical Pharmacy Specialists are responsible for target interdisciplinary programs and clinical services and ensure pharmaceutical care programs are appropriately integrated throughout Baptist Health system. In these clinical roles, System Clinical Pharmacy Specialists participate in all necessary aspects of the medication-use system while supporting comprehensive and individualized pharmaceutical care in their assigned areas.

They also serve as clinical resources and liaisons to other departments, hospital personnel, or external groups. In their role, they may conduct clinical research and practice advancement projects as well as patient care quality and regulatory compliance initiatives designed to improve medication-use processes or pharmacy practice.

The System Clinical Pharmacy Specialist - Neurology and Psychology will serve as subject matter expert for the areas of concentration encompassing all care related to neurology, psychology, neurosurgery, and behavioral health provided throughout the system.

Job Description:

Baptist Health is looking for a System Neurology and Psychology Specialty Pharmacist to join our Pharmacy team! Work from home opportunity.

  • Collaborates withSystem Director of Clinical Services and other BH leaders to implement, integrate, and maintain evidence-based and regulatory standards of clinical/operational pharmacy services with the overall vision for the organization.
  • Works collaboratively with physicians, pharmacists, and other members of the healthcare team to develop clearly defined guidelines, policies, and procedures that promote evidence-based practice to enhance patient outcomes.
  • Ensures timely implementation of initiatives that improve practice and patient outcomes.
  • Contributes to the initiation and development of clinical, quality, and regulatory metrics for pharmacy related clinical services.
  • Must be willing to travel to sites to review and assess practices and processes, as required.
  • Demonstrates expertise in their area(s) of concentration/specialty.
    • Understand the workflow of front-line professional personnel within their areas of expertise. This would include clinics, inpatient units, and other applicable areas of care pertaining to neurology, psychology, neurosurgery, and behavioral health throughout the health system.
  • Represents the pharmacy department and clinical services as an active committee member or invited attendee on system-wide committees or service lines. This would include, but is not limited to:
    • System Pharmacy and Therapeutic Committee
    • Neurology Service Line
    • Neurosurgery Service Line
    • System Residency Advisory Committee
  • May be appointed to serve as a coordinator of the System Residency Advisory Committee. In this role, they would serve as the primary contact for and would assist with the high-level coordination of residency efforts throughout the system.
  • Review neurology protocols for system Collaborative Care Agreements.
  • Complete neurology note reviews and provide feedback to System Pharmacy Credentialing and Privileging Committee.
  • Works collaboratively with clinical staff and physicians to evaluate appropriate medication use at BH. Annually, specialists will be expected to complete medication use evaluations (MUE), continuing education (CE) presentations or in-services (CE preferred), and drug class review. Continued service-line expansions, relevant order set reviews, policy and/or procedure development/modification, and formulary monographs may be required on an as needed basis.
  • Assists in system formulary management to provide safe, effective, and cost-efficient medication use.
  • Serves as a clinical pharmacotherapy specialist for providers, pharmacists, nursing, and other staff on clinically complicated patient cases, investigation of adverse drug events and/or management of drug shortages as needed.
  • Provides verbal and written consultations concerning medication therapy as necessary.
  • Coordinate, facilitate, and promote education, training, competency assessment, and performance improvement of pharmacists, providers, and other healthcare professionals on updates in the applicable area of expertise, as deemed necessary.
  • Provides presentations, publications, and other informative activities relating to area of expertise.
  • Precepts students and residents, as necessary.
  • Establish relationships with local, state, and national organizations/societies to stay informed about community resources and participate in relevant initiatives.
  • Attend conferences and/or workshops as deemed necessary.
  • Responsible for supervising and performing all pharmacy operations in accordance with hospital policies and procedures, ethical and professional practices, accreditation standards, State and Federal requirements and National Patient Safety Goals regarding medication management.

Minimum Education and Training

  • Bachelor's degree in pharmacy or Doctorate of Pharmacy required.
  • Kentucky Board of Pharmacyand Indiana Board of Pharmacy license or willing and eligible to achieve within 6 months of hire.
  • Kentucky license must specify that they are a preceptor.
  • Board certified in their area of expertise or able to achieve within 12 months of hire. Must be one of the following qualifications:
    • Board Certified Psychiatric Pharmacist (BCPP)
    • Board Certified Critical Care Pharmacist (BCCCP)

Experience

  • Must satisfy at least one of the following:
    • Completion of PGY-2 ASHP-accredited Pharmacy Residency in a related area of expertise.
    • Completion of PGY-1 ASHP-accredited Pharmacy Residency and a minimum of 3 years of experience in a related area of expertise AND BPS board certification in that area of expertise as listed above at the time of application.
    • Minimum of 5 years of experience in a related area of expertise AND BPS board certification in that area of expertise as listed above at the time of application.
  • Current Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) certification required or able to achieve within 12 months of hire.

If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now! Baptist Health is an Equal Employment Opportunity employer.


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About Baptist Health South Florida

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Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 27,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence, Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World's Most Ethical Companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Miami, FL, US