- Actalent (Minneapolis, MN)
- Description Your main role will be utilizing your clinical skills to complete utilization management reviews (Prior authorizations, Coverage Exceptions, Quantity ... * Doctor of Pharmacy (PharmD) or equivalent * Current pharmacist license in good standing with the State Board...or feedback to drive results. 4. Ability to make clinical decisions independently 5. Flexibility to change and resourceful… more
- GEHA (Lee's Summit, MO)
- …related to access, affordability, quality, and experience, including business performance, clinical pharmacy operations, PBM and vendor oversight, utilization ... by a nimble and efficient organization. The Director of Pharmacy Operations & PBM Management will guide and improve our Federal Employee Health Benefit (FEHB) and… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …New Contract Year formulary evaluation, and rebate strategy evaluation. The Clinical Pharmacist is the lead for the review and presentation of New Drug ... The Clinical Pharmacist in addition to being...Finance, Case Management, Provider Relations, Compliance, Sales/Marketing and the PBM account team. Responsibilities: + Formulary Management and FRF… 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… more
- Prime Therapeutics (Hartford, CT)
- …our passion and drives every decision we make. **Job Posting Title** Clinical Oncology Pharmacist Principal/BCOP required- REMOTE **Job Description** The ... Principal Clinical Program Pharmacist Prin is responsible for implementing the strategy and...experience in or exposure to the Pharmacy Benefit Management ( PBM ) business + PGY1 pharmacy residency experience preferred **Physical… more
- Elevance Health (NC)
- …industry. **Build the Possibilities. Make an Extraordinary Impact.** **Title** : Pharmacist Clinical **Location(s):** Ohio, Georgia, Indiana, Florida, North ... integration, and ensures essential face-to-face onboarding and skill development.** The ** Pharmacist Clinical ** is responsible for managing the selection and… more
- Elevance Health (San Antonio, TX)
- …treatment journey._ **Build the Possibilities. Make an Extraordinary Impact.** **Title** : Pharmacist Clinical **Location** : 4752 Research Dr., San Antonio, TX. ... work and does not involve any on-call duties. The ** Pharmacist Clinical ** is responsible for managing the...information to the Pharmacy and Therapeutics Committee. + May review and approve or deny coverage for pharmaceuticals (as… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities VA Careers - Pharmacy: https://youtube.com/embed/Fn\_ickNBEwsa. Clinical - Direct Patient Care Activities:1) Functions as an advanced practice… more
- Prime Therapeutics (Cheyenne, WY)
- …our passion and drives every decision we make. **Job Posting Title** Policy Clinical Pharmacist /Oncology exp required - REMOTE **Job Description** Creates new ... not limited to, responding to inquiries, customization of policies, Client policy review , education, QBR support, clinical meetings, audit assistance, special… more
- US Tech Solutions (May, OK)
- …hours shift between 11am to 730pm EST** **Job Description:** + Evaluate and review all prior authorization requests and render coverage determinations based on ... clinical criteria and plan design. Includes verifying insurance coverage...programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business. + Perform other… more
- The Cigna Group (Honolulu, HI)
- **POSITION SUMMARY** Staff Pharmacist , Sr. Manager, Pharmacist In-Charge (PIC) Responsible for the management and performance of clinical pharmacy ... pharmacy licensure where it is located and states requiring Pharmacist in Charge (PIC) to be licensed in order...of staff + Coaching and mentoring a team of clinical and non- clinical direct reports + Resolve… more
- US Tech Solutions (May, OK)
- …of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved ... a Prior Authorization Pharmacist is required. **Skills:** + Prior authorization + PBM **Education:** + Bachelor's degree in pharmacy or Pharm D. Must have an… more
- AmeriHealth Caritas (Philadelphia, PA)
- …are implemented across all applicable lines of business. + Review clinical /financial recommendations and strategies provided by the PBM 's clinical ... and program improvement; plan, implement, and monitor changes. + Review pharmacy utilization reports generated by PBM ,...generated by PBM , in coordination with the PBM clinical team, in a collaborative effort… more
- The Cigna Group (St. Louis, MO)
- …+ Bachelor's degree in Pharmacy, Pharm.D. preferred, with current active US Pharmacist License + 2-4 years of pharmacy/ PBM / Managed Care/healthcare ... is not restricted to locations that are identified in this posting.** Clinical Program Advisor -Supply Chain/Formulary Consulting **JOB SUMMARY** The Clinical … more
- Highmark Health (Wexford, PA)
- …+ Reviews pharmacy utilization management (UM) coverage requests and prepares such cases for clinical review by a pharmacist and/or medical director when ... facts, and cites applicable internal policies and guidelines. (20%) + Resolves non- clinical issues independently and acts as a liaison between our customer and… more
- Mount Sinai Health System (New York, NY)
- …drug utilization review programs to enhance formulary strategies and improve clinical outcomes in alignment with the clinical determination of the Pharmacy ... subject matter expert supporting Mount Sinai Health System. **Qualifications** + Registered Pharmacist required with active licensure in a US state or territory;… more
- The Cigna Group (Helena, MT)
- …pricing and contracting strategies. + Strong operational understanding and competence with PBM clinical programs and product offerings, especially in the ... responsible for leading and managing a team of Pharmacy Clinical Account Manager(s) and/or Pharmacy Account Executive(s) to deliver...to build a strong knowledge of pharmacy and the PBM space within the Medical Sales teams. + Strongly… more
- Prime Therapeutics (Springfield, IL)
- …formulary strategy recommendations, working with partners in negotiation, specialty, clinical , and government programs to formulate aligned recommendations + Partner ... PharmD or Bachelor of Science Pharmacy degree + Current pharmacist license in good standing with the State Board...+ 3 years of related work experience in Trade/Rebates, PBM healthcare or insurance + -OR- + Master's degree… more