- 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
- Humana (Boston, MA)
- …our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health outcomes ... with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the analysis… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …work collaboratively with Pharmacists to provide high-touch, concierge-level pharmacy services to Medicare members. This role focuses on outreach to members who have ... compile member's pharmacy information from multiple sources for the Pharmacist to review + Act as a liaison between...+ Minimum 2-3 years of customer/member service experience + Medicare Part D and/or Pharmacy experience preferred + BS/BA… more
- Highmark Health (Boston, MA)
- … license + 4 years of experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care ... insight for capitated rate negotiations and internal financial forecasting. + Provide clinical expertise, and serve as an influential member of internal clinical… 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
- Tufts Medicine (Boston, MA)
- ** Clinical Liaison - Home Infusion** **Job Profile** **Summary** This role focuses on providing pharmacy related services in a hospital or retail setting. In ... explanation of facts, policies and practices. **Job Overview** The Clinical Liaison serves as an expert clinical ...1. Bachelor's degree in Pharmacy or Nursing. 2. Licensed Pharmacist , Registered Nurse (RN), or Licensed Practical Nurse (LPN).… 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