Role Description

The Clinical Utilization Management Pharmacist is responsible for delivering data-driven clinical and cost-containment strategies that optimize medication utilization, improve patient outcomes, and generate measurable value for long-term care pharmacy clients. This role leads therapeutic interchange initiatives, translates complex analytics into actionable insights, and partners cross-functionally with Clinical Services, Analytics, Operations, Account Management, and Sales to support the organization’s clinical value proposition and differentiation in the marketplace.

This position is a remote position. Applicants may live anywhere within the Continental USA with 10% travel.

Schedule: Salaried, Monday through Friday.

• Lead the design, implementation, and ongoing management of therapeutic interchange and clinical utilization programs to optimize outcomes and contain costs.
• Ensure all clinical initiatives comply with applicable federal and state regulations, professional standards, corporate compliance requirements, and the Company’s Code of Business Conduct and Ethics.
• Support the development and rollout of new clinical programs in partnership with Clinical Services and Operations teams.
• Analyze clinical, utilization, and financial data to identify trends, patterns, and actionable opportunities for clinical improvement and cost containment.
• Translate analytical findings into clear, compelling insights for internal stakeholders and external clients.
• Collaborate with Client Reporting and Analytics teams to define analytical requirements and develop practical business solutions.
• Partner with Account Management and Sales teams to support client reviews, value demonstrations, and consultative discussions.
• Educate internal associates and external stakeholders on clinical programs, therapeutic interchange strategies, and utilization management initiatives.
• Provide clinical expertise in business reviews to demonstrate program effectiveness, outcomes, and return on investment.
• Monitor pharmacy, long-term care, and healthcare industry trends to proactively inform clinical strategy and cost containment recommendations.

Qualifications

• PharmD degree
• Three (3) or more years of experience in clinical pharmacy, utilization management, or a related role
• Strong understanding of geriatric pharmacotherapy and long-term care clinical guidelines
• Demonstrated ability to design and execute targeted clinical and utilization programs
• Advanced analytical, organizational, and presentation skills
• Ability to communicate complex data clearly to both clinical and non-clinical audiences
• Proficiency in Microsoft Excel or pharmacy analytics tools

Requirements

• Analytical thinking and problem-solving
• Strategic planning and execution
• Strong written and verbal communication skills
• Customer-focused and results-oriented mindset
• Ability to collaborate effectively across multidisciplinary teams

Benefits

• Competitive pay
• Health, dental, vision and life insurance benefits
• Company paid STD and LTD
• Employee Discount Program
• 401k
• Paid-time off
• Tuition reimbursement
• Non-retail/Closed-door environment