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Utilization Management Pharmacist Jobs (NOW HIRING)

Judi Health

Formulary Operations Pharmacist

Denver, CO · On-site

$60 - $72/hr

Formulary Operations Pharmacist Charlotte, North Carolina, United States; Denver, Colorado, United ... This individual supports creation and maintenance of formulary and utilization management lists ...

Judi Health

Formulary Operations Pharmacist

Charlotte, NC · On-site

$57 - $68.25/hr

Formulary Operations Pharmacist Charlotte, North Carolina, United States; Denver, Colorado, United ... This individual supports creation and maintenance of formulary and utilization management lists ...

Mindlance

Clinical Pharmacist

$121K - $144K/yr

Clinical Pharmacist - Utilization Management (Remote) Primary Responsibilities: * Review prior authorization and medical exception requests. * Perform utilization review for medical necessity.

Mindlance

Clinical Pharmacist

Rochester, NY · On-site

$116K - $139K/yr

Clinical Pharmacist - Utilization Management (Remote) * Primary Responsibilities: * Review prior authorization and medical exception requests. * Perform utilization review for medical necessity.

Impresiv Health

Health Plan Pharmacist

Huntington Beach, CA · On-site

$61.50 - $74/hr

Support formulary management, utilization management, prior authorization, appeals, and medication ... Active pharmacist license in good standing. * 5+ years of managed care, health plan, PBM, or ...

Capital Rx

Formulary Operations Pharmacist

Denver, CO · On-site

$60 - $72/hr

The Formulary Operations Pharmacist - Medicare is responsible for providing operational support for ... This individual supports creation and maintenance of formulary and utilization management lists ...

Capital Rx

Formulary Operations Pharmacist

Manhattan, NY · On-site

$64.25 - $77.25/hr

The Formulary Operations Pharmacist - Medicare is responsible for providing operational support for ... This individual supports creation and maintenance of formulary and utilization management lists ...

Capital Rx

Formulary Operations Pharmacist

Charlotte, NC · On-site

$57 - $68.25/hr

The Formulary Operations Pharmacist - Medicare is responsible for providing operational support for ... This individual supports creation and maintenance of formulary and utilization management lists ...

Pharmacy Careers

Remote Prior Authorization Pharmacist

$59.50 - $71.75/hr

Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...

Pharmacy Careers

Remote Prior Authorization Pharmacist

$59.50 - $71.75/hr

Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...

Pharmacy Careers

Remote Prior Authorization Pharmacist

$59.50 - $71.75/hr

Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...

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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 7, 2026, the average hourly pay for utilization management 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 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.

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What cities are hiring for Utilization Management Pharmacist jobs? Cities with the most Utilization Management Pharmacist job openings:
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Utilization Management Pharmacist jobs near you
Infographic showing various Utilization Management Pharmacist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $120,850 per year, or $58.1 per hour.

Clinical Pharmacist - Utilization Management Archimedes

Navitus Health Solutions

Remote

$121K - $144K/yr

Other

Re-posted 17 days ago

Navitus Health Solutions rating

7.0

Company rating: 7.0 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

260th of 482 rated business services

Job description

Company
Archimedes
About Us
Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit - alignment, value and transparency - Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. .. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.
Pay Range
USD $0.00 - USD $0.00 /Yr.
STAR Bonus % (At Risk Maximum)
0.00 - Ineligible
Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am to 5pm Hybrid In Office- 3 Days
Overview
Archimedes is a specialty drug management company with industry-leading technology and services that health plans and employer groups can use to manage specialty drug spend. We are expanding our team and looking for a clinical professional who has specialty drug management experience and a passion for cost management. Given our continued growth trajectory, we are looking for a person who can grow with the company.
This role will be divided into two areas: external clinical outreach activities related to high-cost case management and prior authorization of specialty medications, across pharmacy and medical benefits and specialty and traditional drugs. In addition, this role will have the opportunity to evaluate the data to identify actionable opportunities for specialty management and create clinical policies.
The Clinical Pharmacist is responsible for being the clinical expert for all specialty medications across both the pharmacy and the medical benefit. This individual will be able to successfully communicate with physicians, nurses, pharmacists, and members related to high-cost case concerns, dose management, genetic testing, therapeutic substitutions and cost management related to specialty drugs. Clinical subject matter expert is required to conduct peer to peer consultations with physicians.
Position can be located in either our Brentwood, TN or St Louis, MO offices. Remote employment also considered.
Responsibilities
  • Develop and deliver clinical messages to physicians, members, clients, and consultants
  • Manage prior authorization, high-cost cases, claims editing and clinical policy development
  • Clinical program development including both medical and pharmacy benefit management
  • Define, document, and deliver results for plan sponsors.
  • Evaluate and summarize clinical literature as well as financial implications related to medication management options
  • Ability to present deep clinical and cost effectiveness information as a peer-to-peer consult.
Qualifications
  • Doctor of Pharmacy (PharmD)
  • Current pharmacist license (RPh) in good standing with a State Board of Pharmacy
  • Board of Pharmacy Certification, preferred for Pharmacotherapy, Ambulatory Care or Oncology Care
  • 3 years clinical or managed care experience or Clinical/Managed Care Pharmacy Residency preferred.
  • Pharmacy and Medical specialty benefit knowledge and experience
  • Independent, proactive, forward-thinking, creative problem solver, results-oriented
  • Ability to work well in team environment
  • Strong verbal/written communication skills
  • Strong physician-facing clinical communication skills
  • Microsoft Excel, Power Point and Word proficiency

Location : Address
502 Earth City Expy STE 300
Location : City
Earth City
Location : State/Province
MO
Location : Postal Code
63045
Location : Country
US

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