- The Cigna Group (Bloomfield, CT)
- …clinical knowledge and application of chronic condition/population health management. + Direct Managed Care Health Plan and/or Pharmacy Benefit Manager (PBM) ... **Pharmacy Care Navigator - Clinical Pharmacist Part...HEDIS measures. + Previous experience in Medicaid and/or Marketplace/Accountable Care plans. + Previous experience with drug utilization… more
- Staffing Solutions Organization (Albany, NY)
- …the administration and/or development of processes to evaluate managed care plans' pharmacy programs including formularies and/or utilization management ... Licensed NYS Pharmacist - DPDM One Commerce Plaza, Albany, 99...including the activities above and/or with a payer or managed care organization managing clinical programs and/or… more
- Highmark Health (Wilmington, DE)
- …Medicare + Presentation Delivery + Managed Care + Healthcare + Care Planning + Continuous Improvement + Utilization Management + Healthcare Management + ... years in Medicare + 5 - 7 years in Managed Care Support + 3 - 5...+ Board Certified Pharmacotherapy Specialist + Board Certified Ambulatory Care Pharmacist + Board Certified Geriatric … more
- The County of Los Angeles (Los Angeles, CA)
- …meets with pharmaceutical product specialists to discuss current market conditions, managed care implications, disease state management, and obtain information ... Units (MICU, SICU, NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care , Drug Utilization Review, Anti-Coagulation, Purchasing Consultant, Drug… more
- CVS Health (Columbus, OH)
- …the ability to travel up to 40% of the time. **Required Qualifications** : - 3+ years of managed care Pharmacist experience or 1 year of Managed Care ... Summary** : The Clinical Advisor position is an exciting pharmacist opportunity to use your clinical background in a...you will utilize clinical and analytical skills in a managed care environment to positively impact the… more
- Elevance Health (Cincinnati, OH)
- …**Minimum Requirements:** + Requires BA/BS in Pharmacy. + Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; ... skills. **Preferred Skills, Capabilities and Experiences:** + PharmD preferred. + Managed Care Experience specific to formulary, Pharmacy and Therapeutics… more
- CVS Health (Austin, TX)
- …the ability to travel up to 40% of the time. **Required Qualifications** - 3+ years of managed care Pharmacist experience or 1 year of Managed Care ... **Position Summary** The Clinical Advisor position is an exciting pharmacist opportunity to use your clinical background in a...you will utilize clinical and analytical skills in a managed care environment to positively impact the… more
- Elevance Health (Columbus, OH)
- …**Minimum Requirements:** + Requires BA/BS in Pharmacy. + Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; ... working with Medicare and Commercial providers strongly preferred. + PBM or Managed Care experience highly desired. + Proficiency with Excel preferred.… more
- Centene Corporation (Tallahassee, FL)
- … care pharmacy experience. Clinical pharmacy experience in managed healthcare preferred. **License/Certification:** Florida state Pharmacist license with ... competitive benefits including a fresh perspective on workplace flexibility. Clinical Pharmacist - Florida Medicaid **Position Purpose:** Provide timely drug therapy… more
- The Cigna Group (Bloomfield, CT)
- …. Knowledge of regulatory requirements with emphasis on Medicare **Preferred Requirements** . Managed care pharmacy experiential rotation or residency . Two or ... assigned prescribers, and patients. + Proactively conduct analysis of care setting drug utilization data to identify...more years of clinical and/or managed care experience **Must reside near the… more
- BayCare Health System (Clearwater, FL)
- …- ASHP (Pharmacists) **Experience:** + 3 years - Managed Care **Facility:** BayCare Health System, Utilization Management-BHS **Location:** **Park Place** ... area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians.… more
- Prime Therapeutics (Columbus, OH)
- …experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency plus two additional years of ... and drives every decision we make. **Job Posting Title** Pharmacist Account Manager - New York Remote **Job Description...tracks the appropriate metrics to monitor the quality and care cost impact of the client's program. Requires communication… more
- ChenMed (Columbus, OH)
- …preferred, but not required + Experience with supervising Pharmacy Technicians + Experience in a managed care setting (HMO, MSO, PBM) is a plus + Certified to ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...need great people to join our team. The Clinical Pharmacist is a dynamic and experienced Pharmacist … more
- Indian Health Service (Zuni, NM)
- …medication use patterns and outcomes for patients in hospitals or managed care organizations; Performing administrative, consultative, or staff advisory ... full range of clinical services in the emergency room, urgent care , inpatient, obstetrical, optometry, dental, laboratory, radiology, mental health, public health… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …collaboratively to facilitate care using clinical skills, principles of managed care , nationally recognized medical necessity criteria, and company medical ... us transform healthcare? Bring your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for members who may have… more
- Henry Ford Health System (Bingham Farms, MI)
- …and knowledge in patient care and applied therapeutics. Postgraduate experience in primary care or managed care is strongly desired. + Prior experience ... quality of care provided by the primary care team. He/she works with utilization management...be instrumental in guiding the further development of other pharmacist on the health care team. PRINCIPLE… more
- Trinity Health (Maywood, IL)
- …Case manage patients with complex, chronic medical and psychosocial issues. Perform utilization management strategies for those cases managed using the lightest ... Works as part of an Inter-professional team including Social Workers and Pharmacist to develop patient centered plan of care . **Position Requirements:**… more
- Houston Methodist (Houston, TX)
- …Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, formulary processes and medication reconciliation activities while ... include precepting pharmacy students and pharmacy residents on clinical patient care rotations within areas of responsibility and contributing to fulfilling the… more
- Organon & Co. (Plymouth Meeting, PA)
- … while meeting the needs of customers. + Understanding of the local managed care and reimbursement environment relevant to various customer segments and ... their current practice structure, business model, and key influencers (ex: Managed Care Organization/payers, Management Service Organizations (MSOs), employers,… more