- Molina Healthcare (Dallas, TX)
- … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... patient outcomes, medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist , UM will be responsible for reviewing coverage… more
- Molina Healthcare (Houston, TX)
- …and quality initiatives under the direction of leadership. * Monitors drug utilization and assists leadership team in understanding quality and cost-control issues ... pharmacy benefit changes for the upcoming year. * Works with the care management department as part of a member-centered interdisciplinary care team (ICT). * Works… more
- CVS Health (TX)
- …+ Consulting with and recommending standard and custom formulary options and utilization management edits. + Collaborating with internal partners to develop ... drives lowest net cost. + Consulting with and recommending utilization management programs or other clinical programs...Advisor will consult with and advise the Clinical Benefits Pharmacist , and or other members of the Benefits and… more
- Prime Therapeutics (Austin, TX)
- …evaluation for coverage determination requests for prior authorization (PA) or other utilization management ( UM ) programs, including quantity limits, step ... Pharmacist is responsible for the processing and documenting of Utilization Management requests (ie formulary exceptions, prior authorization, step therapy,… more