- UNITAS (River Falls, WI)
- …we are clinicians! About the role The Texas licensed Medicaid Clinical Pharmacist is responsible for the processing and documenting of Utilization Management (UM) ... with team members to promote consistency of clinical decisions across the pharmacist team. Other duties as assigned. Qualifications Current Texas pharmacist … more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare? Bring your true colors to blue. The Pharmacy Operations Clinical Pharmacist Manager manages and directs clinical staff in the day to day ... office 2x per month. Your Day to Day: Partner with Clinical Pharmacy and PBM Clinical teams to assist with strategic planning, development, and implementation of new… more
- A-Line Staffing Solutions (Orlando, FL)
- Job Description Now Hiring: Remote Prior Authorization Pharmacist We're seeking experienced Prior Authorization Pharmacists (not retail) for a fully remote ... opportunity. If you have a background in Pharmacy Benefits Management ( PBM ) and meet the requirements below, apply today! Position Details: Training Schedule: Monday… more
- UnitedHealth Group (Los Angeles, CA)
- …simply do not exist in any other organization, anywhere. The Account Manager Pharmacist / Clinical Consultant will lead and manage ongoing contract relationships and ... degree in Pharmacy or Pharm D Current and unrestricted Pharmacist license 2+ years of client facing or clinical...facing or clinical account management experience OR health plan PBM management experience 1+ years of Medicare experience Experience… more
- OnePoint Patient Care (Vancouver, WA)
- Our Company OnePoint Patient Care Overview We are looking for a Pharmacist to join our team of providing the highest quality of care, reliability, and support to our ... patients, caregivers, and families. In this role, the Pharmacist will be responsible for dispensing medications, providing clinical advice, as well as delivery… more
- Actalent (Chicago, IL)
- Remote Clinical Review Pharmacist - 100% Remote, Entry Level PBM $55/hr | Full-Time | Contract-to-Hire | 100% Remote Ready to move beyond the retail counter and ... contract with high conversion likelihood Start window: September-October Must hold an active pharmacist license in good standing (any US state except CA, HI, or VA)… more
- Actalent (Modesto, CA)
- …triage coverage determination requests submitted from providers and determine if a pharmacist review is required. You will also obtain verbal authorizations and ... criteria, and enter and document coverage determination request decisions into the PBM system. Additionally, you will notify providers and/or members, respond to… more
- MedStar Health (Washington, DC)
- …evaluation. Supports regulatory requirements under the supervision of the health plan pharmacist . NCQA - Completes letter mailings and other outreach in accordance ... Pharmacy Operations activities. Reviews and finalizes monthly, quarterly and annual PBM reports. Supports maintenance of PA metrics dashboard. Serves as a… more
- Actalent (Westerville, OH)
- …determinations to approve or deny these authorizations, which are then sent to a Pharmacist for final review. You will handle all health plans and types of ... issues and/or escalated member issues. Escalate prescription-related questions to a Pharmacist for interpretation or processing direction. Assist with inbound and/or… more
- US Tech Solutions (May, OK)
- …as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM (Pharmacy Benefits Management) required. + Since the job duties consist of ... candidates with that experience are preferred. **Skills:** + Prior authorization + PBM **Education:** + Bachelor's degree in pharmacy or Pharm D. Must have… more
- CVS Health (Austin, TX)
- …the United States. **Required Qualifications** * 2 years' experience working as a pharmacist in a PBM setting. Current experience working within Commercial Prior ... each and every day. Ready to take your Clinical Pharmacist skills to the next level with a Fortune...Authorizations in Caremark PBM ** * Experience using clinical resources, eg, Micromedex, Lexicomp,… more
- Actalent (Tallahassee, FL)
- …prior authorizations, coverage exceptions, and quantity limit exceptions. As a pharmacist , you will work independently within a team of pharmacy professionals ... + Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree. + Current pharmacist license in good standing with the State Board of Pharmacy in the state… more
- Actalent (Chicago, IL)
- 100% Remote Clinical Review Pharmacist Job Description Your primary role will involve utilizing your clinical skills to perform utilization management reviews, ... + Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree. + Current pharmacist license in good standing with the State Board of Pharmacy where the… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Health Plan Pharmacy leader that will oversee pharmacy clinical operations, PBM relationship, formulary, utilization management, and other pharmacy programs and lead ... Consulting to drive business outcomes. The **Director, Pharmacy Operations & PBM Management** will provide direction and oversight in Premera's Pharmacy strategy,… 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
- 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 ... be responsible for all aspects of Formulary maintenance and management. The Clinical Pharmacist may also be required to meet with prescribers on a one-on-one basis… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare? Bring your true colors to blue. The Pharmacy Operations Clinical Pharmacist Manager manages and directs clinical staff in the day to day ... Day to Day: + Partner with Clinical Pharmacy and PBM Clinical teams to assist with strategic planning, development,...issues. What You Bring: + Minimum of professional Registered Pharmacist degree required. Graduate study in a business, public… more
- US Tech Solutions (May, OK)
- **Job Title:** ** Pharmacist Operations Advisor** **Location: Remote** **Duration: 6+ months contract** **Shift: 8 hours shift between 11am to 730pm EST** **Job ... Description:** + The Pharmacist /Clinician is an operation-based role that conducts criteria based...setting ie, specialty medical office or Pharmacy Benefits Manager ( PBM ) **Skills:** + MUST HAVE MANAGED CARE exp and… more
- Elevance Health (Mason, OH)
- …**Build the Possibilities. Make an Extraordinary Impact.** **Title** : Clinical Pharmacist Sr. **Location(s):** Iselin, NJ, Atlanta, GA, Indianapolis, IN, Mason, OH, ... unless an accommodation is granted as required by law.** The **Clinical Pharmacist Sr.** is responsible for developing and implementing pharmacy programs. We are… more
- Elevance Health (Miami, FL)
- …industry. **Build the Possibilities. Make an Extraordinary Impact.** **Title** : Pharmacist Clinical **Location(s):** Miami, FL Hybrid: This role requires associates ... a dynamic and adaptable workplace. The **Population Health Management Pharmacist ( Pharmacist Clinical** ) is responsible for...+ Minimum of 2 years of managed care pharmacy ( PBM ) experience or residency in lieu of work experience;… more
