Remote PharmD Utilization Management Pharmacist

1w1 week ago

Sagility

US · Full-time · $104,000 – $104,000

About this role

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. Elevate your career by applying your PharmD in a role that values clinical judgment, analytical thinking, and attention to detail. Join a team supporting critical healthcare decisions behind the scenes without the retail environment.

In this full-time, non-patient-facing position, review medication requests like Prior Authorizations, Formulary Exceptions, Step Therapy, and Quantity Limit exceptions. Apply clinical guidelines and client criteria to determine coverage decisions. Interpret complex clinical scenarios and provide clear documentation supporting decisions.

Work from home in a structured environment with core hours from 8:00 AM to 6:00 PM Central Time. Collaborate with pharmacists and team members to ensure consistency and accuracy. Meet productivity and quality benchmarks while supporting a culture of accuracy, accountability, and continuous learning.

Become part of a team that S.O.A.R.s: Spark Curiosity, One Team One Direction, Action for Results, Right by Right Purpose. Enjoy paid training in a cutting-edge virtual environment and comprehensive health coverage. Contribute to meaningful healthcare outcomes through independent work and evidence-based care.

Requirements

Doctor of Pharmacy (PharmD) degree
Active pharmacist license in good standing
2–3 years of experience supporting U.S. healthcare pharmacy or utilization management processes preferred
Strong clinical judgment and problem-solving skills
Comfortable working independently in a structured environment
Strong written communication and documentation skills
Ability to learn new systems quickly and manage multiple applications simultaneously
Detail-oriented with strong focus on accuracy and quality
Hardwired internet connection with minimum speeds of 25 Mbps download and 10 Mbps upload
Secure, private workspace free from distractions

Responsibilities

Evaluate clinical requests such as Prior Authorizations (PA), Formulary Exceptions (FE), Step Therapy (ST) requests, and Quantity Limit (QL) exceptions
Apply clinical guidelines and client criteria to determine coverage decisions
Interpret complex clinical scenarios and provide clear documentation supporting decisions
Collaborate with pharmacists and team members to ensure consistency and accuracy
Consult with healthcare providers when clarification is needed regarding clinical requests
Meet productivity and quality benchmarks while maintaining strong attention to detail
Support a culture focused on accuracy, accountability, and continuous learning