Supervisor, Utilization Management Pharmacist

1 hour, 33 minutes ago
Full-time
Junior
Customer and Technical Support
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017

Description

  • Supervise a group of clinical pharmacists handling escalations, prior authorizations, and clinical program outreach.
  • Participate in goal setting and review direct reports’ performance, providing coaching as needed.
  • Support training for current staff and onboarding for new clinical pharmacists.
  • Develop and maintain job aids, policies, and procedures.
  • Analyze data with leadership and recommend staffing, workflow, and system improvements.
  • Identify and apply career development opportunities for employees.
  • Perform daily clinical pharmacy work, including prior authorization and appeal reviews and override requests.
  • Handle inbound and outbound member and provider education or peer-to-peer calls.
  • Support clinical programs by triaging calls and conducting outreach to prescribers, pharmacies, and members.
  • Provide after-hours on-call support on a rotating schedule, including nights, weekends, and holidays.

Requirements

  • Active, unrestricted pharmacist license.
  • Bachelor's or Doctor of Pharmacy degree.
  • 2+ years of pharmacy practice experience.
  • Experience in customer service, call center, and prior authorization work.
  • Excellent communication, writing, and organizational skills.
  • Ability to work independently in a remote, high-volume, metric-driven call center environment.
  • Self-motivated, detail-oriented, and able to solve problems effectively.
  • Ability to manage multiple competing priorities and collaborate in a team.
  • Designated private workspace with a closed door and low noise during work hours.
  • Wired DSL, cable, or fiber internet connection with 1 gigabyte (940bps) speed; Wi‑Fi is not allowed.
  • Working knowledge of MS Office.
  • 2+ years of experience as a clinical pharmacist in a Pharmacy Benefit Management (PBM) setting (preferred).

Benefits

  • Fully remote work environment.
  • Salary range of $128,000-$160,000 for New York, NY.
  • Salary range of $117,600-$147,000 for Denver, CO.
  • Salary range of $106,800-$133,500 for Charlotte, NC.

Interested in this position?

Apply directly on the company website

Apply Now

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