Supervisor, Utilization Management Pharmacist

Judi Health

$117K — $147K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Active, unrestricted pharmacist license
  • Bachelor's or Doctor of Pharmacy Degree with 2+ years of experience
  • Experience in customer service, call center and prior authorization
  • Excellent communication, writing, and organizational skills
  • Ability to work independently in a remote, high-volume environment
  • Self-motivated, detail-oriented problem solver
  • Working knowledge of MS Office
  • 2+ years as a clinical pharmacist in a PBM setting

Responsibilities

  • Oversee clinical pharmacists handling phone escalations and prior authorization reviews
  • Participate in goal setting and performance reviews of direct reports
  • Support training and onboarding of new clinical pharmacists
  • Analyze data to recommend staffing and workflow enhancements
  • Identify career development opportunities for employees
  • Perform clinical pharmacy functions including prior authorization and appeal reviews
  • Meet performance metrics while providing superior customer service
  • Support clinical programs with outreach and triaging clinical calls

Benefits

  • Fully remote work environment
  • Opportunity for professional growth and development
  • Engagement in meaningful patient care initiatives
  • Collaborative team dynamics
  • Flexible responsibilities to meet organizational goals
Full Job Description
Position Summary:
Join a mission-driven team where your leadership directly enhances patient care. In this role, you'll oversee a group of clinical pharmacists, support key clinical programs, and stay engaged in hands-on clinical work like prior authorizations and provider outreach. You'll also play a vital role in mentoring staff, optimizing workflows, and collaborating across teams. This is a great opportunity for pharmacists looking to grow their careers while making a meaningful impact-all in a fully remote, high-performing, and collaborative environment.

Position Responsibilities:
  • Responsible for the supervision of a group of clinical pharmacists handling phone escalations from members, prescribers, and pharmacists, prior authorization reviews, and clinical programs outreach.
  • Participate in the goal setting process and regularly review performance of direct reports, providing coaching when needed.
  • Support on-going training of current staff and onboarding new clinical pharmacists, including developing and maintaining job aids and/or policies and procedures.
  • Work in conjunction with other leadership in analyzing available data and provide staffing, workflow and system enhancement recommendations.
  • Identify and apply career development opportunities for employees.
  • Perform day to day clinical pharmacy functions including prior authorization and appeal reviews, override requests, and inbound and outbound member and provider education or peer-to-peer calls.
  • Meet or exceed performance metrics while maintaining quality and providing superior customer service to all stakeholders.
  • Provide support for clinical programs as needed, including triaging incoming clinical calls and conducting outreach calls to prescribers, pharmacies, and members.
  • Provide on call support as needed for after-hours pharmacist/clinical programs/emergent calls on rotating schedule that includes nights, weekends and holidays.
  • Work collaboratively with internal business and clinical partners to support initiatives including clinical interventions, clinical programs, data and claims review, and on-boarding of new clients, as required.
  • Support Manager, Utilization Management with additional duties as assigned.


Required Qualifications:
  • Active, unrestricted pharmacist license
  • Bachelor's or Doctor of Pharmacy Degree with 2+ years of pharmacy practice experience
  • Experience in customer service, call center and prior authorization required
  • Excellent communication, writing, and organizational skills
  • Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environment
  • Self-motivated and detail-oriented problem solver
  • Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team
  • Have a designated workspace (an office, spare bedroom, etc) that is visibly secure from others during work hours (closed door) and is protected from noise that could disrupt conversations
  • Have the following internet connectivity: DSL, cable modem or fiber with a wired connection to device (wi-fi not allowed). Internet speed of one gigabyte (940bps) is required
  • Working knowledge of MS Office
  • 2+ years of experience as a clinical pharmacist in a Pharmacy Benefit Management (PBM) setting.


New York, NY Salary Range

$128,000-$160,000 USD

Denver, CO Salary Range

$117,600-$147,000 USD

Charlotte, NC Salary Range

$106,800-$133,500 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

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