- NFP (Chesterfield, MO)
- …claim, eligibility, COBRA, and customer service problems. Serve as liaison to VPS' PBM partners to resolve problematic clinical issues. With input from external ... experience in clinical consulting and analysis of pharmaceutical products and clinical programs. Preferably with a PBM or Health System. Qualifications &… more
- MedImpact (San Diego, CA)
- …include the following. Other duties may be assigned. Responsible for providing clinical review support services to client plan(s) contracting for clinical ... the request. Support services also include, but not limited to, clinical review, analysis, recommendation, decision and documentation of prior authorization… more
- Insight Global (Boston, MA)
- …preparation, labeling, and distribution of these products to help facilitate clinical trials research. This position will ensure compliance with regulatory standards ... being followed at all times. Working under the supervision of a licensed pharmacist (s) within the research space, the technician will assist with sterile and… more
- Actalent (Annapolis, MD)
- …will be responsible for approving or denying requests and forwarding them to a pharmacist for final review. This role involves handling all health plans and types of ... authorizations. Approve requests based on criteria and enter decisions into the PBM system. Notify providers and members of decisions. Respond to client inquiries… more
- Actalent (Chicago, IL)
- 100% Remote Clinical Review Pharmacist Job Description Your primary role will involve utilizing your clinical skills to perform utilization management ... (PharmD) or Bachelor of Science Pharmacy degree. + Current pharmacist license in good standing with the State Board...2+years of work experience in retail, managed care, or clinical pharmacy. Work Environment This is a fully remote… more
- Actalent (Tallahassee, FL)
- …Benefits Management Company!! Job Description This role involves utilizing clinical skills to conduct utilization management reviews, including prior authorizations, ... coverage exceptions, and quantity limit exceptions. As a pharmacist , you will work independently within a team of...+ 2+years of experience in retail, managed care, or clinical pharmacy. Work Environment This is a fully remote… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …seeking a strategic Health Plan Pharmacy leader that will oversee pharmacy clinical operations, PBM relationship, formulary, utilization management, and other ... related to access, affordability, quality, and experience, including business performance, clinical pharmacy operations, PBM and vendor oversight, utilization… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- The Clinical Pharmacist in addition to being responsible for the daily Clinical Pharmacist operations and decision-making process related to coverage ... will be responsible for all aspects of Formulary maintenance and management. The Clinical Pharmacist may also be required to meet with prescribers on… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. The Pharmacy Operations Clinical Pharmacist Manager manages and directs clinical staff in the ... per month. Your Day to Day: + Partner with Clinical Pharmacy and PBM Clinical ...issues. What You Bring: + Minimum of professional Registered Pharmacist degree required. Graduate study in a business, public… more
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. Ready to take your Clinical Pharmacist skills to the next level with a Fortune 6 company? Check out ... this outstanding opportunity for a Clinical Pharmacist with CVS Health. This position...**Required Qualifications** * 2 years' experience working as a pharmacist in a PBM setting. Current experience… more
- Elevance Health (Mason, OH)
- …industry. **Build the Possibilities. Make an Extraordinary Impact.** **Title** : Clinical Pharmacist Sr. **Location(s):** Iselin, NJ, Atlanta, GA, Indianapolis, ... for employment, unless an accommodation is granted as required by law.** The ** Clinical Pharmacist Sr.** is responsible for developing and implementing pharmacy… more
- Elevance Health (Miami, FL)
- …the industry. **Build the Possibilities. Make an Extraordinary Impact.** **Title** : Pharmacist Clinical **Location(s):** Miami, FL Hybrid: This role requires ... a dynamic and adaptable workplace. The **Population Health Management Pharmacist ( Pharmacist Clinical ** ) is...+ Minimum of 2 years of managed care pharmacy ( PBM ) experience or residency in lieu of work experience;… more
- State of Arkansas (Little Rock, AR)
- …Number: 22181851 County: Pulaski Anticipated Starting Salary: $118,399.01 Position Summary The Pharmacist will function as the PBM Division Manager. The ... PHARMACIST Date: Jul 24, 2025 Req ID: 51416...PBM Division Manager organizes and monitors all PBM -related complaints, licensing, and renewal activities. The Manager also… more
- CVS Health (Buffalo Grove, IL)
- …CVS Health has an exciting opportunity to join our growing team as a Clinical Development Pharmacist ! Are you looking for a clinically interesting role that ... be the role you are looking for! As a Clinical Development Pharmacist , you will create and...Qualifications :** - Residency or BCPS. - Knowledge of PBM and benefit design preferred - 3+ years of… more
- Elevance Health (Overland Park, KS)
- …industry. **Build the Possibilities. Make an Extraordinary Impact.** **Title** : Clinical Pharmacist **Location(s):** Indianapolis, IN, Durham, NC, Overland ... an accommodation is granted as required by law.** The ** Pharmacist Clinical ** is responsible for managing the...+ Minimum of 2 years of managed care pharmacy ( PBM ) experience or residency in lieu of work experience;… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to help us transform healthcare? Bring your true colors to blue. The Clinical Pharmacist Reviewer reviews formulary exception, prior authorization and quantity ... Medical Utilization Management for pharmaceuticals programs + Partner with clinical and non- clinical teams for staff training,...from MAPS, Health and Medical Management, IT & Ops, PBM account support team and other customer service areas… more
- Elevance Health (San Antonio, TX)
- ** Clinical Pharmacist Clinical 1 (PRN)**...+ Minimum of 2 years of managed care pharmacy ( PBM ) experience or residency in lieu of work experience; or ... for employment, unless an accommodation is granted as required by law. The ** Clinical Pharmacist Clinical 1 (PRN)** is responsible for managing the selection… more
- Elevance Health (Cincinnati, OH)
- …role in the industry. **Build the Possibilities. Make an Extraordinary Impact.** Clinical Configuration Pharmacist **Location:** This role requires associates to ... an accommodation is granted as required by law._ The ** Clinical Configuration** ** Pharmacist ** is responsible for managing...+ Minimum of 2 years of managed care pharmacy ( PBM ) experience or residency in lieu of work experience;… more
- CVS Health (Pittsburgh, PA)
- …it all with heart, each and every day. **Position Summary** The Medical Specialty Clinical Pharmacist will be responsible for development and execution of ... specialty programs and services across our Book of Business. The Medical Specialty Clinical Pharmacist will be responsible for managing and executing long-term… more
- Elevance Health (Mason, OH)
- ** Clinical Pharmacist - CarelonRx** ** **...Pharmacy. Minimum of 2 years of managed care pharmacy ( PBM ) experience or residency in lieu of work experience; ... (formerly IngenioRx) leverages the power of new technologies and a strong, clinical -first lens, to deliver member-centered, lasting pharmacy care. The ** Clinical … more
