- Molina Healthcare (Long Beach, CA)
- … (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
- Highmark Health (Wexford, PA)
- …in accordance with all regulatory agency requirements ESSENTIAL RESPONSIBILITIES Reviews pharmacy utilization management ( UM ) coverage requests and prepares ... such cases for clinical review by a pharmacist and/or medical director when required. (20%) Within the...(5%) May perform other non-clinical duties as required by management and department needs. QUALIFICATIONS Required 2 years of… more
- Molina Healthcare (Bellevue, NE)
- … (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
- CVS Health (Buffalo Grove, IL)
- …long-term and ongoing departmental and enterprise initiatives. Knowledge of utilization management interventions including prior authorization, step therapy, ... and demonstrated prior authorization experience - Demonstrated understanding of utilization management interventions including prior authorization, step therapy,… more
- CVS Health (New York, NY)
- …oncology pharmaceuticals, disease management and therapeutics. Knowledge of utilization management interventions including prior authorization, step therapy, ... each and every day. **Position Summary** As a Clinical Development Oncology Pharmacist , you will create and maintain clinical content for specialty oncology drugs… 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 ... clinical operational UM activities to ensure that all Commercial (Pharmacy and...development, and implementation of new Clinical Pharmacy and Drug Utilization initiatives to ensure quality, affordable care. + Collaborate… more
- Actalent (Fargo, ND)
- …your primary responsibility will be leveraging your clinical skills to complete utilization management ( UM ) reviews-including prior authorizations, coverage ... Now Hiring: Pharmacist - 100% Remote | $55/hr | Consultant-to-Hire...Join a dynamic team where your expertise powers critical utilization management decisions that directly affect patient… more
- CVS Health (Buffalo Grove, IL)
- …pharmaceuticals, disease management and therapeutics. Knowledge of utilization management interventions including prior authorization, step therapy, ... to join our growing team as a Clinical Development Pharmacist ! Are you looking for a clinically interesting role...You should have experience interpreting drug information to support UM . Knowledge of regulations impacting UM for… more
- Highmark Health (Harrisburg, PA)
- …managing or supervising clinicians (such as pharmacists, nurses, or other clinicians) in a utilization management operations setting in a PBM or Health Plan. + ... clinical pharmacy strategies and other pharmacy strategy teams to execute on the formulary/ utilization ( UM ) and other strategic pharmacy products. This job will… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
- Highmark Health (Wexford, PA)
- …with all regulatory agency requirements **ESSENTIAL RESPONSIBILITIES** + Reviews pharmacy utilization management ( UM ) coverage requests and prepares ... such cases for clinical review by a pharmacist and/or medical director when required. (20%) + Within...+ May perform other non-clinical duties as required by management and department needs. **QUALIFICATIONS** **Required** + 2 years… more
