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UCLA Health Utilization Management Clinical Pharmacist in Los Angeles, California

Responsibilities

Take on a significant role with a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. UCan do all this and more at UCLA Health.

As an integral member of the UCLA Medical Group Utilization Management team, you will be responsible for assessing the medical necessity of pharmacy-related authorizations. You will partner with the Medical Director of Utilization Management as well as other key internal/external stakeholders as you review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria. You will also ensure compliance with all regulatory requirements. You will need to remain current on issues related to pharmacy medical necessity, low-cost alternatives, and appropriateness in order to serve as a subject matter expert on best practices for pharmaceutical appropriate use.

Qualifications

We're seeking a detail-oriented, self-motivated professional with:

  • California Pharmacist license

  • PharmD degree preferred

  • Two or more years of experience with pharmacy and medical claims data

  • Experience in health plan, PBM, or managed care a plus

  • In-depth knowledge of electronic medical record systems

UCLA Health is a world-renowned health system with four award-winning hospitals and dozens of primary care practices, specialty practices, urgent care centers and other ancillary locations throughout metro Los Angeles as well as the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.

UCLA is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.

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