- CVS Health (Boston, MA)
- …experience. **PRIMARY DUTIES AND RESPONSIBILITIES** : Ensure accuracy of case setup and clinical review of Medicare appeals cases + Review internal notes or ... As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related...cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The Clinical Pharmacist , In-House Clinical Programs is responsible for working with ... management with identifying and resolving drug-related problems for participants . The clinical pharmacist will assist the Pharmacy Department in the measurement… more
- Medical Mutual of Ohio (OH)
- …with relevant experience may be considered. . 3 years of experience as a Clinical Pharmacist or equivalent experience in a managed care pharmacy setting. . ... by facilitating regular interactions to build and support the clinical relationship. . Assists in closing Medicare ... Medicare /Medicaid experience preferred. Professional Certification(s) . Registered … more
- Medical Mutual of Ohio (OH)
- …Bachelor of Pharmacy with relevant experience. . 5 years of experience as a Clinical Pharmacist in a managed care pharmacy setting. . Medicare /Medicaid ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Develops strategies and… more
- CVS Health (Pittsburgh, PA)
- …(Pharmacy Benefit Management) environment + Demonstrated understanding of CVSH clinical portfolio, marketplace segments dynamics ( Medicare , Medicaid, Exchange, ... make health care more personal, convenient and affordable. **Position Summary** The Clinical Operations Advisor is a client facing role that collaborates with Health… more
- US Tech Solutions (May, OK)
- **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You ... for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more… more
- CareFirst (Baltimore, MD)
- …the offices a few times/month or more often as needed.** **PURPOSE:** The Clinical Pharmacist Specialty Drug Strategy will perform comprehensive clinical ... - Licensed Pharmacist Active in any state and/or DC Registered Pharmacist .** **Experience:** 5 years experience in clinical pharmacy, preferably in a… more
- Lancaster General Health (Lancaster, PA)
- **Summary** Full-time Clinical Pharmacist Position - central and decentralized pharmacy services. Sign on Bonus w/ 2 -year commitment. Pharmacist Clinical ... alternate therapies as appropriate. Demonstrates this activity by preparing clinical intervention documentation. + Prepares and dispenses medications in accordance… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to help us transform healthcare? Bring your true colors to blue. The Clinical Pharmacist Reviewer reviews formulary exception, prior authorization and quantity ... requests from providers via phone and fax for the Retail Pharmacy, Medicare Advantage Part D, Home Infusion Therapy, and Medical Utilization Management benefits.… more
- Humana (Miami, FL)
- …a part of our caring community and help us put health first** The Clinical Pharmacist Lead monitors drug development pipelines and medical literature while ... to mitigate cost trend and improve health outcomes. The Clinical Pharmacist Lead works on problems of...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Healthfirst (NY)
- …Students + Ensure all clinical criteria is in compliance with Center of Medicare and Medicaid Services (CMS) and the New York State Department of Health (NYSDOH) ... with the latest guidelines or otherwise supported by the clinical compendia + Provide clinical pharmacy support...degree from an accredited school of pharmacy + Registered Pharmacist , with a state license in good standing +… more
- Atlantic Health System (Morristown, NJ)
- Job Responsibilities The Emergency Medicine Pharmacist will provide support to the Emergency Department (ED) and offer patient-centered services in a ED setting. The ... Emergency Medicine Pharmacist will participate in multidisciplinary committees and serve as...+ Provide comprehensive pharmaceutical care to our patients including: clinical intervention; teaching and pharmacy representation on various committees;… more
- Healthfirst (NY)
- … criteria and medical policies for the review of medications. + Ensure all clinical criteria follows Center of Medicare and Medicaid Services (CMS) and the ... Job Description **Duties and Responsibilities:** + Responsible for developing clinical criteria, medical policies for provider administered medications, review of… more
- US Tech Solutions (AZ)
- **Job Title:** ** Pharmacist ** **Location: Remote** **Duration: 12+ months contract** **Job Description:** + As an RPh Advisor you will be directly supporting ... Medicare Part D members and providers with requests related...cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to… more
- CVS Health (Fort Wayne, IN)
- …of clinic location required + 1-3 years' prior relevant experience as a Clinical pharmacist -Ambulatory experience preferred + Completion of all required ... prescriptions to helping manage chronic and specialty conditions. The Pharmacist , Ambulatory Care plays a critical role at CVS...evolve over time): + Work as part of a clinical care team to improve patient satisfaction, lower medical… more
- Elevance Health (Columbus, OH)
- …lens, to deliver member-centered, lasting pharmacy care. The **Population Health Management Pharmacist ( Pharmacist Clinical ** ) is responsible for managing ... **Population Health Management Pharmacist - CarelonRx** **Location:** The ideal candidate will...the selection and utilization of pharmaceuticals and supports core clinical programs for contracted provider groups formulary management, achieving… more
- Highmark Health (Wilmington, DE)
- …Serve as the clinical SME for PCP value based reimbursement programs, Medicare STARS, Medicaid HEDIS, for both the Organization's internal and external key stake ... + Board Certified Ambulatory Care Pharmacist + Board Certified Geriatric Pharmacist **SKILLS** + Analytical Skills + Medicare + Presentation Delivery +… more
- AdventHealth (Columbus, NC)
- …**101 HOSPITAL DR, Columbus, 28722** **The role you'll contribute:** The ** Clinical Pharmacist ** is responsible for the effective implementation, integration, ... providing certain consulting and support services to Adventhealth Polk. The Clinical Pharmacist facilitates the development, implementation, and maintenance of… more
- Cedars-Sinai (Beverly Hills, CA)
- …people?** This role is considered a hybrid role. As a Drug Use Policy Pharmacist (DUP) at the Cedars-Sinai Medical Network Foundation, you will serve as the primary ... professional staff member in the Department of Pharmacy responsible for the clinical and medication use policies within Cedars-Sinai Medical Care Foundation (CSMCF).… more
- Indian Health Service (Gallup, NM)
- …training programs. Assists in designing and completing research studies involving clinical pharmacist functions, quality assurance, drug use evaluations, or ... this position is to serve as a Antimicrobial Stewardship Ambulatory/Inpatient Pharmacist . The incumbent is primarily concerned with maintenance of the Antimicrobial… more