- Healthfirst (NY)
- …appropriate billable units based on dosing, indication, weight, BMI and other clinical considerations + Develop clinical criteria and medical policies for ... the review of medications + Ensure all clinical criteria is in compliance with Center of Medicare...criteria is in compliance with Center of Medicare and Medicaid Services (CMS) and the New York State Department… more
- Healthfirst (FL)
- …are consistent with the latest guidelines or otherwise supported by the clinical compendia + Provides clinical pharmacy support to pharmacy technicians ... + Precepts Pharmacy Residents and Students + Ensures all clinical criteria is in compliance with Center of Medicare...criteria is in compliance with Center of Medicare and Medicaid Services (CMS) and the New York State Department… more
- Molina Healthcare (Columbus, OH)
- Molina Healthcare is hiring for a Pharmacist in our UM/Prior Authorization department. This position is remote and can be worked from a variety of locations ... requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug… more
- Centene Corporation (Olympia, WA)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... Define and develop standard and custom formularies for assigned plan. + Develop clinical criteria for medications, recommend plan design changes, and clinical … more
- US Tech Solutions (RI)
- …reviews. + Transfers all clinical questions, escalations and judgement calls to the pharmacist team. + The Rep I, Clinical Services will also assist with ... status and results (seniors, pharmacists, appeals, etc). + Identify and elevate clinical inquiries to the pharmacist team as appropriate. **Experience:** +… more
- Arab Community Center for Economic and Social Serv (Dearborn, MI)
- …testing, and Point of Care testing + Provide smoking cessation opportunities with clinical pharmacist + Document details of engagement with clients + Conduct ... to assist the individual/family + Aid clients in obtaining healthcare services ( Medicaid , family planning, connections to medical homes, etc.) + Completes (or closes… more