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Um Pharmacist Jobs (NOW HIRING)

Lthc

Clinical Pharmacist, Utilization Management

Dewitt, MI · On-site

$99K - $118K/yr

The focus of the UM Pharmacist is to manage the quality, appropriateness, safety and cost of medications for our members through the medical management of drugs across our pharmacy and medical ...

Lthc

Clinical Pharmacist, Utilization Management

Dewitt, MI · On-site

$99K - $118K/yr

The focus of the UM Pharmacist is to manage the quality, appropriateness, safety and cost of medications for our members through the medical management of drugs across our pharmacy and medical ...

Lthc

Clinical Pharmacist, Utilization Management

Albany, NY · On-site

$117K - $140K/yr

The focus of the UM Pharmacist is to manage the quality, appropriateness, safety and cost of medications for our members through the medical management of drugs across our pharmacy and medical ...

Lthc

Clinical Pharmacist, Utilization Management

Dewitt, MI · On-site

$99K - $118K/yr

The focus of the UM Pharmacist is to manage the quality, appropriateness, safety and cost of medications for our members through the medical management of drugs across our pharmacy and medical ...

Lthc

Clinical Pharmacist, Utilization Management

Utica, NY · On-site

$121K - $144K/yr

The focus of the UM Pharmacist is to manage the quality, appropriateness, safety and cost of medications for our members through the medical management of drugs across our pharmacy and medical ...

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Um Pharmacist information

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How much do um pharmacist jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for um 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 does a UM pharmacist do?

A UM (Utilization Management) Pharmacist is responsible for reviewing medication requests to ensure they are clinically appropriate, cost-effective, and in line with healthcare policies and guidelines. They collaborate with healthcare providers, insurance companies, and patients to evaluate prescription drug use and manage formularies. Their work helps optimize patient outcomes while controlling pharmacy benefit costs and reducing unnecessary or inappropriate medication usage.

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

To thrive as a Pharmacist, you need a Doctor of Pharmacy (Pharm.D.) degree, state licensure, and a strong understanding of pharmacology and medication therapy management. Familiarity with pharmacy management systems, prescription processing software, and drug information databases is typically required. Excellent communication, attention to detail, and problem-solving skills set standout pharmacists apart. These skills and qualifications are crucial for ensuring safe, effective medication use and providing optimal patient care.

What are some common challenges faced by UM pharmacists?

Pharmacists in utilization management often encounter the challenge of balancing cost-effectiveness with optimal patient care by reviewing and making determinations on medication requests. They must stay current with clinical guidelines and formulary changes, which requires continuous learning and adaptability. Additionally, UM pharmacists frequently collaborate with physicians, nurses, and insurance providers, which necessitates strong communication and negotiation skills to resolve disagreements and ensure the best outcomes for patients. The role can be fast-paced, with strict deadlines for prior authorizations and appeals, making time management a key skill.

What is the difference between Um Pharmacist vs Community Pharmacist?

AspectUm PharmacistCommunity Pharmacist
CredentialsPharmacy degree, licensurePharmacy degree, licensure
Work EnvironmentHospitals, clinics, healthcare facilitiesRetail pharmacies, drugstores
Employer & IndustryHealthcare institutions, hospitalsPharmacy chains, independent drugstores
Common Search & ComparisonSimilar roles in healthcare settingsPatient counseling, medication dispensing

Um Pharmacist typically works in healthcare settings like hospitals and clinics, focusing on patient care and medication management. Community Pharmacists operate in retail pharmacies, providing medication dispensing, patient counseling, and health advice. Both roles require similar credentials but differ mainly in work environment and daily responsibilities.

What are popular job titles related to Um Pharmacist jobs?

For Um Pharmacist jobs, the most frequently searched job titles are:

Infographic showing various Um Pharmacist job openings in the United States as of August 2026, with employment types broken down into 1% Internship, 2% As Needed, 70% Full Time, 25% Part Time, and 2% Contract. Highlights an 98% Physical, and 2% Remote job distribution, with an average salary of $120,850 per year, or $58.1 per hour.

Pharmacist, UM-Formulary Oversight - Hybrid

Manhattan, NY • On-site

EmblemHealth
Insurance Services • 1 - 5K employees
Learn more about EmblemHealthexternal

$64.25 - $77.25/hr

Other

Re-posted 18 days ago

EmblemHealth rating

9.4

Company rating: 9.4 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

15th of 315 rated insurance

Job description


Summary of Job

Responsible for setting Pharmacy UM criteria and decision tree oversight. Review and maintain UM criteria (e.g., prior authorization (PA) and step therapy) for clinical appropriateness and alignment with P&T decisions. Advise Operations team on vendor configuration for UM setup. Partner with pharmacist Formulary, UM, and analytics teams to select annual formulary. Partner with Finance and Pharmacy analytics to finalize disruption analysis and monitor medical drug rebates. Provide formulary analysis for strategy opportunities, collaborate with Ops/Product strategy team to inform benefit design. Advise pharmacy benefits manager (PBM) and operations team to implement formulary and prior authorization criteria. Monitor key PGs, KPIs, and trends in utilization, authorization, and operations; report metrics to Formulary and UM Pharmacist Manager and Clinical Pharmacy Director. Provide sound clinical judgment and subject matter expertise of State and Federal regulations to ensure compliance with regulatory and contractual obligations.

Responsibilities

  • Responsible for development, implementation, and maintenance of preferred formulary drug lists.
  • Responsible for preferred drug lists for key clinical areas including primary care, pediatrics, dermatology, cardiology, ophthalmology, rheumatology, hematology/oncology, gastroenterology.
  • Develop preferred formulary drug lists across all lines of business: Medicare Part D, Medicaid, Commercial, Healthcare Exchange.
  • Evaluate and maintain formulary set-up based on clinical requirements, compliance with regulatory bodies, and P&T rules.
  • Maintain clinical tools utilized by pharmacy services for purpose of remaining up to date and compliant with current pharmacy policies.
  • Provide education on new formulary updates including quarterly formulary changes and annual 1/1 changes.
  • Serve as subject matter expert for all escalated clinical formulary related issues as well as for all formulary related internal and external audits.
  • Review weekly reports to identify trends and compliance.
  • Work with IT to maintain preferred drug list updates.
  • Identify and target prescribing outliers.
  • Work with actuary to determine cost saving alternatives for preferred drug list.
  • Manage the Pharmacy & Therapeutic Committee/Formulary Management, including Step-Protocol Review, NonFormulary Review, Subcommittee Management (Meetings/minutes), Drug Reviews, and Updates and Drug Policies, for all medications.
  • Report formulary compliance to senior leadership.
  • Other duties/projects as assigned

Qualifications

  • Doctor of Pharmacy degree
  • PGY-1 or PGY-2 In Ambulatory Care, Geriatrics, Internal Medicine, or Managed Care (Preferred)
  • Registered Pharmacist: Registered Pharmacist license (Requred)
  • 10 - 12+ years of relevant experience (Requred)
  • Residency or 5 years' clinical experience (Preferred)
  • Knowledge of formulary utilization management techniques (Requred)
  • Knowledge of pharmaceuticals and disease states to provide advice and consultation to providers and members and recommend changes to the formulary (Requred)
  • Possess research and analytical skills sufficient to provide problem resolution and consultation to providers (Requred)
  • Excellent verbal and written communication skills sufficient to prepare own correspondence and interact with members and providers in provision of advice and guidelines (Requred)
Additional Information
  • Requisition ID: 1000003266
  • Hiring Range: $92,880-$178,200

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