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Remote Utilization Management Pharmacist Jobs in Rochester, NY

Mvphealthcare

Concurrent Review - RN

Rochester, NY · Remote

$69K - $92K/yr

Ideal for experienced RNs looking to expand into utilization management, this position provides ... Whereyou'llbe: Location: Remote Pay Transparency MVP Health Care is committed to providing ...

IDEX

Assistant Controller

West Henrietta, NY · On-site +1

... utilization, and labor/burden studies Participate in analysis of consolidated operations/cost ... This position is a remote role; however, we are seeking candidates who reside within reasonable ...

Athena

LCSW Clinical Supervisor - Remote

Rochester, NY · Remote

... management of assigned therapists when necessary * Perform ongoing review of high-risk cases and provide clinical solutions as appropriate * Engage in the Utilization Review process for assigned ...

All JobsUtilization Management Pharmacist JobsRemote Utilization Management Pharmacist JobsRemote Utilization Management Pharmacist Jobs in Rochester, NY

Remote Utilization Management Pharmacist information

See Rochester, NY salary details

$18

$57

$85

How much do remote utilization management pharmacist jobs pay per hour?

As of Jul 7, 2026, the average hourly pay for remote utilization management pharmacist in Rochester, NY is $57.33, according to ZipRecruiter salary data. Most workers in this role earn between $46.01 and $67.84 per hour, depending on experience, location, and employer.

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 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.

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 the most commonly searched types of Utilization Management Pharmacist jobs in Rochester, NY? The most popular types of Utilization Management Pharmacist jobs in Rochester, NY are:
What are popular job titles related to Remote Utilization Management Pharmacist jobs in Rochester, NY? For Remote Utilization Management Pharmacist jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management Pharmacist jobs in Rochester, NY look for? The top searched job categories for Remote Utilization Management Pharmacist jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Remote Utilization Management Pharmacist jobs? Cities near Rochester, NY with the most Remote Utilization Management Pharmacist job openings:
Remote Utilization Management Pharmacist jobs near you
Infographic showing various Remote Utilization Management Pharmacist job openings in Rochester, NY as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $119,239 per year, or $57.3 per hour.
Health Insurance & Authorization Specialist II

Health Insurance & Authorization Specialist II

Highland Hospital

Rochester, NY • On-site, Remote

$20.99 - $28.34/hr

Other

Posted 17 days ago

Highland Hospital (New York) rating

7.7

Company rating: 7.7 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

209th of 1,004 rated hospitals

Job description

he Health Insurance and Authorization Specialist is responsible for verifying patient insurance eligibility and coverage and securing third-party payer authorization for our urgent/emergent inpatients, observation cases, maternity, and newborn admissions and notifies Utilization Management of clinical requests during the hospital stay.  The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case Management team to assess patients for health insurance or financial assistance.  They track our Medicare patients for benefit exhaustion to ensure compliance with Medicare Life Time Reserve (LTR) consent forms and consistently exercise judgment to resolve insurance barriers on the assigned admissions to avoid billing delays.  This role involves a more significant amount of external coordination with outside agencies, including MVA/WC carriers, Motor Vehicle Accident Indemnification Corporation (MVAIC) agency, attorney offices, and works with parents to add their newborn through the NYS Marketplace or employer group.
Supervision:              Responsible for monitoring own performance on assigned tasks.  Self-directed and must make complex decisions independently.  May train other support staff.
                                   
                                    This role may have the option to work a hybrid-remote schedule and communicate daily through virtual meetings.
Salary Range:
$20.99-  $28.34 an hour
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

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