Utilization Management Pharmacist - Prior Authorization

Capital District Physicians Health Plan Inc. seeks a licensed NYS pharmacist to manage utilization management across Medicare, Commercial, Exchange and Medicaid lines.

You will review prior authorizations, medical necessity, and appeals, while supporting providers and staff to ensure safe, effective and cost-efficient medication use. Level I–III responsibilities include audits, training new hires, updating criteria, and cross‑functional collaboration with clinical teams to improve patient