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Utilization Management Pharmacist Jobs in Michigan

Pharmacy Careers

Remote Clinical Review Pharmacist

Detroit, MI · On-site

$108K - $129K/yr

Collaborate with physicians, nurses, and utilization-management teams on complex cases. * Document ... S. pharmacist license. * Experience: Clinical review, utilization management, or managed care ...

New

Pharmacy Careers

Appeals Pharmacist (Remote)

Grand Rapids, MI · On-site

$53.25 - $64.75/hr

Experience: Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists with strong documentation and clinical skills are encouraged to apply. * Skills:

New

Lthc

Utilization Management Services Rep I

Dewitt, MI

$13.50 - $18.25/hr

... pharmacists, and support staff. * Provide one-on-one support, coaching, and training to UM Services Reps. * Collaborates with other key departments (Claims, Customer Service, related care management ...

Lthc

Utilization Management Services Rep I

Dewitt, MI · On-site

$13.50 - $18.25/hr

... pharmacists, and support staff. * Provide one-on-one support, coaching, and training to UM Services Reps. * Collaborates with other key departments (Claims, Customer Service, related care management ...

CVS Health

MI · On-site

$110K - $249K/yr

Position Summary The Clinical Advisor position is an exciting opportunity for pharmacists to ... Demonstrated experience in Formulary and Utilization Management within PBM environment * Commitment ...

divvyDOSE

Specialty Pharmacist Full Time

Marshall, MI · On-site

$44 - $79/hr

Specialty Pharmacist Explore opportunities with CPS, part of the Optum family of businesses. We're ... Oversee prior authorizations and utilization management, ensuring compliance with payer and program ...

UMR

Specialty Pharmacist Per Diem

Owosso, MI · On-site

$44.09 - $78.70/hr

Oversee prior authorizations and utilization management, ensuring compliance with payer and program ... Active pharmacist license in good standing in the state of Michigan Preferred Qualifications:

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Utilization Management Pharmacist information

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How much do utilization management pharmacist jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for utilization management pharmacist in Michigan is $50.64, according to ZipRecruiter salary data. Most workers in this role earn between $40.62 and $59.90 per hour, depending on experience, location, and employer.

What are the typical responsibilities of a utilization management pharmacist, and how do they interact with other healthcare professionals?

As a Utilization Management Pharmacist, your daily responsibilities often include reviewing medication requests for appropriateness, evaluating coverage under insurance plans, and ensuring adherence to clinical guidelines. You will regularly collaborate with physicians, nurses, case managers, and insurance representatives to optimize medication therapy and manage prior authorizations. Providing clinical recommendations, supporting appeals processes, and participating in the development of drug utilization policies are also common aspects of the role. This position offers a blend of independent decision-making and teamwork, allowing you to have a meaningful impact on patient care while coordinating with a variety of healthcare professionals.

What are the key skills and qualifications needed to thrive in the utilization management pharmacist position, and why are they important?

To thrive as a Utilization Management Pharmacist, candidates typically need a Doctor of Pharmacy (PharmD) degree, current pharmacist licensure, and a solid understanding of clinical guidelines and formulary management. Familiarity with pharmacy benefit management (PBM) software, electronic medical records (EMR) systems, and utilization review processes is commonly required, along with certification such as Board Certified Pharmacotherapy Specialist (BCPS) being advantageous. Strong analytical skills, attention to detail, effective communication, and the ability to work collaboratively with healthcare providers make someone stand out in this position. These competencies are crucial for ensuring safe, effective, and cost-efficient medication use while supporting optimal patient outcomes within healthcare organizations.

What is a utilization management pharmacist?

A Utilization Management Pharmacist is responsible for evaluating prescription drug use to ensure cost-effective and evidence-based treatment. They review prior authorization requests, assess medication appropriateness, and collaborate with healthcare providers to optimize patient outcomes. They work in insurance companies, pharmacy benefit managers (PBMs), or healthcare organizations to enforce formulary compliance and reduce unnecessary healthcare costs. Their role helps balance patient care with financial stewardship by ensuring medications meet clinical guidelines and coverage policies.

What are the most commonly searched types of Utilization Management Pharmacist jobs in Michigan? The most popular types of Utilization Management Pharmacist jobs in Michigan are:
What are popular job titles related to Utilization Management Pharmacist jobs in Michigan? For Utilization Management Pharmacist jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Utilization Management Pharmacist jobs in Michigan look for? The top searched job categories for Utilization Management Pharmacist jobs in Michigan are:
Utilization Management Pharmacist jobs near you
Infographic showing various Utilization Management Pharmacist job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 1% Temporary, and 4% Contract. Highlights an 91% Physical, 4% Hybrid, and 5% Remote job distribution, with an average salary of $105,333 per year, or $50.6 per hour.

Utilization Review Nurse

Healthcare Support Staffing

Troy, MI

Contractor

Re-posted 13 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Company: Molina Healthcare

Location: 880 Long Lake Rd Suite 600 Troy, Michigan 48098

Shift: Daytime hours

Employment: Contract: 1-2 months (possibility of going longer depending on business needs)


Company Job Description/Day to Day Duties:


Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines


Provider appeals and Utilization reviews and assist with Denial Letters 


Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.

Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care. 

Qualifications

Minimum Education/Qualifications/Licensures:


Must be an RN 

Utilization Review background in either Managed Care of Provider environment (at least one year) 

Interqual experience 

Other basic computer skills necessary: Microsoft Office, Data Entry, etc. 

Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.

Also has a background in patient, skilled nurses facilities, rehab, and home healthcare.  

Additional Information

Apply now for immediate consideration. After applying, a recruiting consultant will contact you for pre-screening. Please provide your best phone number to contact.

Thanks and look forward to hearing from you!

Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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