- Point32Health (Canton, MA)
- …the direction of the Pharmacy Utilization Management (UM) Supervisor, the Per Diem Clinical Pharmacist is responsible for reviewing, processing and managing the ... for coverage determinations (CD), and exceptions. The Per Diem Clinical Pharmacist ensures timely disposition of reviews...MedHOK system a plus. Knowledge of or experience with Medicare Part B & D, Medicaid, and Drug Utilization… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while ... to mitigate cost trend and improve health outcomes. The Clinical Pharmacist Lead works on problems of...Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a… more
- Prime Therapeutics (Boston, MA)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director ... is responsible for the management of all client specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management… more
- Fallon Health (Boston, MA)
- …the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
- Prime Therapeutics (Boston, MA)
- …an environment of collaboration and communication; partner with leaders across clinical , sales and client engagement to bring competitive opportunities to market ... of corporate recommendations to committee(s); partner with cross-functionally with Clinical Program Management, Specialty, Health Plan Markets and other internal… more
- Highmark Health (Boston, MA)
- …to obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document ... offerings and rules/regulations across multiple states. They must also be familiar with Medicare drug benefit design offerings that may differ by state, while being… more