Clinical Utilization Pharmacist - Prior Authorization Expert
Listed on 2026-10-15
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Healthcare
Clinical Pharmacist, Healthcare Compliance
Health First seeks a Clinical UM Pharmacist to review prior authorization requests, develop clinical criteria, and ensure policy compliance with CMS and NYSDOH. You will collaborate with physicians and Medical Directors to discuss clinical rationale for decisions.
The role requires a NY-licensed pharmacist with at least 1 year of prior authorization experience, strong writing and communication skills, and a solid pharmacotherapy knowledge base. Knowledge of billing practices is a plus.
As a Clinical Utilization Pharmacist - Prior Authorization Expert, you will play an important part at Health First in Las Vegas, NV, United States.
The position is based in Las Vegas, NV, United States.
This opportunity is part of our work in Legal, Bio & Pharmacology & Health.
The advertised compensation is 103..
We aim to respond to suitable candidates as soon as possible.
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