- Highmark Health (Harrisburg, PA)
- …**Preferred** + Board Certified Pharmacotherapy Specialists (BCPS) + Board Certified Ambulatory Care Pharmacist (BCACP) **SKILLS** + Strong verbal and written ... communication skills + Microsoft Office (Outlook, Word, Excel) + Managed care experience with fundamental understanding of formulary management and … more
- 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
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …regulations with rule making and State Plan Amendments and review and approve Managed Care Organizations (MCO) and Magellan Medicaid Management (MMA) policies, ... development and stimulation of services of others, and the utilization of available resources in the most effective manner....Level of Work: Advanced. Supervision Received: General from a Pharmacist 4 or other high-level health care … more
- CVS Health (Pittsburgh, PA)
- … Care setting (PBM or managed care environment) and/or completion of managed care residency . Active pharmacist license that is in good standing . ... Power Point and Visio **Demonstrated Knowledge of:** . PBM and Managed Care . Formulary Management . Utilization Management . Drug File and Adjudication… 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 (Harrisburg, PA)
- …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
- Houston Methodist (Houston, TX)
- … Pharmacist Resident position supports the delivery of pharmacy managed protocols, formulary processes and medication reconciliation activities while providing ... At Houston Methodist, the Pharmacist Resident position is responsible for participating in...to achieve optimal department results. Collaborates with other health care professionals as needed for problem resolution and/or achievement… 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
- Essentia Health (Bismarck, ND)
- …+ Successful completion of a residency program preferred + Experience in managed care , formulary management, or medication therapy management preferred ... prior authorizations (PA), evaluating and supporting appeals requests, and conducting utilization management functions. The pharmacist will collaborate with… more
- CVS Health (Oklahoma City, OK)
- …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
- CVS Health (Phoenix, AZ)
- …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
- 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 within the… more
- CVS Health (Pittsburgh, PA)
- … pharmacist license that is in good standing - 2+ years of managed care experience/Prior Authorization experience - 1+ years experience of clinical ... to join our growing team as a Clinical Development Pharmacist ! Are you looking for a clinically interesting role...PBM and benefit design preferred - 3+ years of Managed Care or PBM experience **Education :**… more
- ChenMed (Miami, FL)
- …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
- Healthfirst (NY)
- …in a dynamic environment with various opportunities **Preferred Qualifications:** + PGY1 Managed Care Residency (optional) + Knowledge of regulations of the ... Pharmacy degree from an accredited school of pharmacy is required + Registered Pharmacist with a state license in good standing required + Strong clinical knowledge… more
- Indian Health Service (Polacca, AZ)
- …medication use patterns and outcomes for patients in hospitals or managed care organizations; Performing administrative, consultative, or staff advisory ... This position is for the Chief of Pharmacy Services at the Hopi Health Care Center located in Polacca, Arizona. Incumbent is responsible for all matters pertaining… more
- Actalent (Eagan, MN)
- …and productivity goals. Hard Skills + Two (2) years of work experience in retail, managed care , or clinical pharmacy. + Doctor of Pharmacy (PharmD) or Bachelor ... Job Title: Clinical Review Pharmacist (100% Remote) Job Description Your main role...role will be utilizing your clinical skills to complete utilization management reviews (Prior authorizations, Coverage Exceptions, Quantity Limit… more
- Healthfirst (NY)
- …billing practices in the medical and pharmacy benefits **Preferred Qualifications:** + PGY1 Managed Care Residency + Knowledge of regulations of the Centers for ... NYSDOH + Work across departments as needed to complete Utilization Management reviews + Review monthly reports and provide...degree from an accredited school of pharmacy + Registered Pharmacist with a state license in good standing. +… more
- VNS Health (Manhattan, NY)
- …+ Minimum of two years of pharmacy experience Required + Experience in a managed care and/or clinical care setting and geriatric pharmacy management, ... (PBM) clinical pharmaceutical services. + Participates in Quality Improvement projects; Utilization Review; Individual Drug Profile Review; and Pharmacy Standard and… more
- UTMB Health (Huntsville, TX)
- …States** Allied Health UTMB Health Requisition # 2404136 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... Clinical Staff Pharmacist - Huntsville Central Pharmacy **Huntsville, Texas, United...of safe, effective, and timely medication therapy through drug utilization review and collaboration with other healthcare professionals. Responsible… more