- Elevance Health (Atlanta, GA)
- ** Medicaid Formulary Pharmacist Clinical - CarelonRx** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... -first lens, to deliver member-centered, lasting pharmacy care. The ** Pharmacist Clinical ** will be responsible for managing...management. **How you will make an impact:** + Leads Medicaid formulary management processes. + Responsible for… more
- CVS Health (Atlanta, GA)
- …least 2 and up to 4 market segments for any particular client (Medicare, Medicaid , Exchange, or Commercial). The Health Plan Clinical Advisor is responsible for ... Clinical Advisor will consult with and advise the Clinical Benefits Pharmacist , and or other members...any federal, state or local regulatory requirements that impact formulary , UM and or clinical programs and… more
- Molina Healthcare (Columbus, GA)
- …state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider ... utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and… more
- Molina Healthcare (Macon, GA)
- …**Job Summary** Provides support and subject matter expertise for pharmacy formulary liaison activities between the business and its customers (members, providers ... to the pharmacy benefit. * Serves as the designated formulary expert. * Ensures Molina is compliant with the...quality metrics. * Assists call center pharmacy technicians with clinical questions and phone calls from prescribers, pharmacies and/or… more
- Highmark Health (Atlanta, GA)
- …to obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document ... member claims history, clearly defines the medical necessity of non- formulary and prior authorization medication exception requests. Interacts with pharmacy… more
- Prime Therapeutics (Atlanta, GA)
- …an environment of collaboration and communication; partner with leaders across clinical , sales and client engagement to bring competitive opportunities to market ... ensure manufacturers' products are brought forth internally to evaluate rebate and formulary opportunities for Prime's business + Provide key leadership within Trade… more