• Medicaid Pharmacy Director

    Humana (Frankfort, KY)
    …on problems of diverse scope and complexity ranging from moderate to substantial. The Medicaid Pharmacy Director , internally known as a Clinical Pharmacy ... our caring community and help us put health first** The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical… more
    Humana (02/27/24)
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  • Director , Pharmacy Government…

    CareFirst (Baltimore, MD)
    …compliance, population health, and/or member/provider experience. + Analyzes Medicare and Medicaid pharmacy and medical drug utilization data to identify ... Maryland office; therefore, candidates must live within driving distance.** **PURPOSE:** Director , Pharmacy Government Programs is responsible for implementing… more
    CareFirst (04/19/24)
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  • Director - Hospital Pharmacy

    Marshfield Clinic (Marshfield, WI)
    …together to support the most exciting missions in the world!** **Job Title:** Director - Hospital Pharmacy Services - Marshfield Medical Center **Cost Center:** ... (United States of America) **Job Description:** **JOB SUMMARY** The Director of Hospital Pharmacy Services is an...participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must… more
    Marshfield Clinic (04/24/24)
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  • Executive Director , Aetna Pharmacy

    CVS Health (Phoenix, AZ)
    …outcomes and lower health care costs. Caremark is recruiting for an Executive Director of Aetna Pharmacy Solutions who is responsible for end-to-end delivery ... of Aetna's Medicaid , Medicare, and SSI EGWP Pharmacy Benefits...plan administration, requirements, configuration, clinical and quality. The Executive Director has ownership of the successful delivery of Exchange… more
    CVS Health (03/29/24)
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  • Clinical Pharmacy & FQHC Policy Specialist

    State of Colorado (CO)
    Clinical Pharmacy & FQHC Policy Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4466251) Apply  Clinical Pharmacy & FQHC Policy ... Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health… more
    State of Colorado (04/16/24)
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  • SHP Pharmacy Benefits Specialist (Remote)

    Marshfield Clinic (Marshfield, WI)
    …of the SHP pharmacy benefits. This individual works closely with the Pharmacy Director , Clinical Pharmacy Specialist, and Operations Manager to provide ... support the most exciting missions in the world!** **Job Title:** SHP Pharmacy Benefits Specialist (Remote) **Cost Center:** 682891381 SHP- Pharmacy **Scheduled… more
    Marshfield Clinic (04/12/24)
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  • Technician-Specialty Pharmacy

    Baptist Memorial (Covington, TN)
    …assistance for their prescriptions. The individual in this position supports the BSP Director , BSP Pharmacy Staff and Clinical Pharmacists to ensure that all ... patients are getting the most out of their specialty pharmacy services. The Pharmacy Technician - Specialty...communication occurs + Understand The Centers for Medicare & Medicaid Services (CMS) regulations and billing guidelines and complete… more
    Baptist Memorial (04/05/24)
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  • Medical Director - Medical Affairs…

    CVS Health (Springfield, IL)
    …Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified Oncologist for this opportunity.The ... of clinical leadership to various internal departments (eg, specialty pharmacy services, clinical product development, Enterprise Analytics, Compliance, Legal,… more
    CVS Health (04/16/24)
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  • Director , Clinical Account Services…

    Prime Therapeutics (Columbus, OH)
    …that are the responsibility of the Vendor. Requirements: + Extensive knowledge of Medicaid and NMAP claims processing and pharmacy benefits management. + At ... and drives every decision we make. **Job Posting Title** Director , Clinical Account Services - Remote Nevada **Job Description...pharmacy experience. + 5+ years of experience in Pharmacy Benefits Management (PBM), Health plan or Medicaid more
    Prime Therapeutics (04/04/24)
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  • Senior Director of BH Clinical Programs

    WellSense (Boston, MA)
    Senior Director of BH Clinical Programs WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through ... Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical...the Senior Vice President of Behavioral Health, the Senior Director of BH Clinical Programs oversees the BH Care… more
    WellSense (04/06/24)
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  • Associate Medical Director , Hospitalist…

    Lancaster General Health (Lancaster, PA)
    **Summary** **Job Description** **POSITION SUMMARY:** The Associate Medical Director , Hospitalist Services is responsible for assisting the Medical Director , ... as representative of the LGHP Hospitalists practice. The Associate director will report to LGHP Medical Director ...by CMS and the applicable State health department and Medicaid agency + Assist in developing, coordinating, and participating… more
    Lancaster General Health (04/16/24)
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  • Sr Director , Value Based Pricing…

    Prime Therapeutics (Columbus, OH)
    …exclusions, and rebate rates. **Responsibilities** + Knowledge of and experience with Medicaid pharmacy practice, managed care pharmacy practice, and/or ... our passion and drives every decision we make. **Job Posting Title** Sr Director , Value Based Pricing - Preferably on the West Coast **Job Description Summary**… more
    Prime Therapeutics (04/23/24)
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  • Behavioral Health Medical Director

    Humana (Richmond, VA)
    …first** Humana Healthy in Virginia is in search of a Behavioral Health Medical Director who will oversee our behavioral health (BH) clinical program for Medicaid ... collaborate closely with the Associate VP, Clinical Services, the Director , BH & Addictions and Recovery Treatment Services (ARTS),...the development of new products and services in Humana's Medicaid BH delivery model. + Leads clinical and quality… more
    Humana (02/17/24)
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  • Women's Health Account Director - North…

    Organon & Co. (Naperville, IL)
    **Job Description** **The Position** Under the guidance of the Director , Commercial Operations-Women's Health, the Women's Health Account Director (WH-AD) is the ... of contact for Organon for the following: + State Medicaid & Managed Medicaid Plans + State...Local Commercial Payers not covered by Regional Payer Account Director (RPAD). + Group Purchasing Organizations (GPOs) not covered… more
    Organon & Co. (04/24/24)
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  • Medical Director Aetna Duals Center…

    CVS Health (Columbus, OH)
    …"base plan" and in the round robin based on "same or similar specialty" needs. * Pharmacy coverage - The medical director will perform pharmacy reviews. * ... to its membership. Aetna is looking for a medical director to be part of a centralized team that...+ years of experience in managed care (Medicare and/or Medicaid ) Experience with managed care (Medicare and Medicaid more
    CVS Health (03/19/24)
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  • Associate Director , Corporate Accounts

    CSL Behring (King Of Prussia, PA)
    …brands within a defined group of Specialty Pharmacies, Commercial Payors (MCOs), Pharmacy Benefit Managers (PBMs) and Medicaid FFS. This includes acting ... The Associate Director , Corporate Accounts is responsible for managing all...+ Represents CSL Behring at key Payor/PBM and Specialty Pharmacy conferences. Contributes to training on appropriate topics for… more
    CSL Behring (03/29/24)
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  • Director , Specialty Clinical Solutions-…

    Prime Therapeutics (Columbus, OH)
    …passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- PharmD/RPH required- REMOTE **Job Description Summary** ... Responsible for support and development of Medical Pharmacy program strategy as part of the Medical Pharmacy Business Development team. Responsible for managing… more
    Prime Therapeutics (04/12/24)
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  • Sr. Director , Client Services…

    Omnicell, Inc. (Grapevine, TX)
    …access to all possible payors; working with clients to gain access to Specialty Pharmacy Networks; oversight of the Pharmacy Licensing team; and pharmacy ... and in any other way possible to ensure smooth openings. + Ensures all pharmacy state licenses, and non-resident licenses are current; all Medicaid , DEA,… more
    Omnicell, Inc. (02/03/24)
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  • Associate Director , Access Reimbursement…

    Sage Therapeutics (Austin, TX)
    …large geographical region. + Understanding of national and state legislative, Medicare, Medicaid , and private payer and pharmacy coverage initiatives affecting ... Sage Therapeutics is currently recruiting for an Associate Director Access Reimbursement Management to join their National Access Reimbursement Manager (ARM) team… more
    Sage Therapeutics (03/30/24)
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  • Collection Manager- Infusion Pharmacy

    BrightSpring Health Services (Englewood, CO)
    …home infusion providers in the country. The Collection Manager will report to the Director of Revenue Cycle Management and work in our Centennial, CO office. Amerita ... of all Accounts Receivable, including but not limited to Medicare, Medicaid , commercial insurances and patient balances. The Collection Manager will perform… more
    BrightSpring Health Services (03/26/24)
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