Pharmacist - Utilization Management (UM) - (Remote)

Highmark Health

Grandview Heights, Franklin County95494 - 95494📅 17/9/2026

Descripción

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical po…

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