Springfield, MO · On-site +1
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential ... Many DUR roles offer hybrid or fully remote schedules. * Rewards: Competitive salary, benefits, and ...
Springfield, MO · On-site +1
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential ... Many DUR roles offer hybrid or fully remote schedules. * Rewards: Competitive salary, benefits, and ...
Springfield, MO · Remote
$49 - $59/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Springfield, MO · Remote
$49 - $59/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Springfield, MO · On-site +1
$48.25 - $58.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Springfield, MO · On-site +1
$48.25 - $58.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Springfield, MO · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and setting your own schedule. We are looking for an existing Medical Expert (this is an independent ...
Quick apply
Springfield, MO · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and setting your own schedule. We are looking for an existing Medical Expert (this is an independent ...
Springfield, MO · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and setting your own schedule. We are looking for an existing Medical Expert (this is an independent ...
Quick apply
Springfield, MO · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and setting your own schedule. We are looking for an existing Medical Expert (this is an independent ...
$19.46 - $23.40
2% of jobs
$23.40 - $27.33
9% of jobs
$30.03 is the 25th percentile. Wages below this are outliers.
$27.33 - $31.27
21% of jobs
The median wage is $34.45 / hr.
$31.27 - $35.20
23% of jobs
$35.20 - $39.14
13% of jobs
$42.20 is the 75th percentile. Wages above this are outliers.
$39.14 - $43.08
10% of jobs
$43.08 - $47.01
8% of jobs
$47.01 - $50.95
5% of jobs
$50.95 - $54.88
5% of jobs
$54.88 - $58.82
2% of jobs
$58.82 - $62.76
2% of jobs
$19
$38
$62
To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.
A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.
A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.
Other
Medical
Posted 20 days ago
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications
A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role is ideal for pharmacists who enjoy analyzing medication use, applying clinical guidelines, and collaborating with providers to promote safe, cost-effective care.
Key Responsibilities
What You'll Bring
Why This Role?
About Us
We are a confidential healthcare partner providing managed care pharmacy services nationwide. Our DUR pharmacists play a key role in ensuring that medications are used safely, appropriately, and cost-effectively across diverse patient populations.
Apply Today
Advance your career in managed care pharmacy - apply now for our Drug Utilization Review Pharmacist opening and help lead the way in improving medication safety and outcomes.
