Pharmacist, Utilization Management (PA) & Appeals
$67.5k - $126kSanta Barbara Cottage Hospital
A healthcare organization is seeking a Registered Pharmacist to review requests for medication coverage determinations. The role involves evaluating clinical information against medical policy criteria, conducting research as needed, and ensuring accurate claims processing. The ideal candidate has a Bachelor's degree in Pharmacy, 1-3 years of relevant experience, and strong communication skills. This position is office-based, offering a pay range of $67,500 to $126,000. #J-18808-Ljbffr Santa Barbara Cottage Hospital
$125k
...full-service pharmacy benefit management (PBM) solutions to self-... ...Position Summary The Clinical Care Pharmacist plays a vital role in... ...decisions on prior authorizations, appeals, and override requests using... ...accreditation (URAC/NCQA) utilization review standards. Provide...SuggestedTemporary workLocal areaRemote workWeekend work- ...Appeals Pharmacist Ensure Fair Medication Access for Patients A confidential managed care organization is seeking an experienced Appeals Pharmacist to review, evaluate,... ...license in the U.S. Prior managed care or utilization management experience preferred retail and...SuggestedRemote job
- Humana Inc is seeking a Utilization Management Clinical Pharmacist 2 to join our community. This role focuses on conducting medical necessity reviews for prescriptions, analyzing medication plans, and communicating recommendations to optimize patient outcomes. The ideal...SuggestedRemote jobFlexible hours
- ...Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role...SuggestedRemote work
- A-Line Staffing Solutions is seeking a Pharmacist Operations Advisor to support Medicare Part D members and providers with pharmacy benefit requests. This remote role focuses on accurate case setup, clinical review, and ensuring compliance with Medicare guidelines. Ideal...SuggestedRemote job
$120k - $140k
...we’re scaling rapidly, and looking for a Forward Deployed Pharmacist who can run real pharmacy workflows and grow into a customer... ...steps that slow down medication access: intake, coordination, utilization management, and clinical services. Role and Responsibilities:...Work at officeLocal areaRemote work3 days per week- ...organization is seeking a motivated Remote Prior Authorization Pharmacist to improve patient access to effective therapies. This 100% remote position allows pharmacists to utilize their clinical judgment in managed care. Ideal candidates will have a PharmD, active...Remote jobFlexible hours
- The Clinical Optimization Pharmacist serves as a key member of PACE and/or Hospice interdisciplinary... ..., providing comprehensive medication management and clinical support to patients,... ...(EHR) and pharmacy management systems. Utilize clinical software, artificial intelligence...Full timeLocal areaRemote work
$92.88k - $178.2k
...As part of the Comprehensive Medication Management Program, conduct interviews, develop,... ...and optimizing patient outcomes, drug utilization and patient compliance, detecting and/or... ...of pharmacy ~ Current, unrestricted Pharmacist License in accordance with a respective...Work experience placement3 days per week$96.71k
...and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding... ...interpretation, profiling of cost and utilization plan data, provider relations and implementation... ...B.S. and current unrestricted NY state Pharmacist license are required. Doctorate in...Full timeContract workPart timeFlexible hours- ...MTM Pharmacist - Help Patients Get the Most Out of Their Medications Are you passionate about patient care and looking for a... ...life balance? We're seeking MTM Pharmacists (Medication Therapy Management) to join our growing team. In this role, you'll use your...Remote work
$96.71k - $116.06k
...and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding... ...interpretation, profiling of cost and utilization plan data, provider relations and implementation... ...B.S. and current unrestricted NY state Pharmacist license are required. Doctorate in...Full timeContract workPart timeWork at officeFlexible hours- ...Case Management Pharmacist - Coordinate Care and Improve Patient Outcomes A confidential managed care organization is hiring a detail... ...drug interactions. Support prior authorization and appeals processes when needed. Educate patients and caregivers...Remote work
- ...Under the direction of the collaborative clinical team lead, performs clinical services relating to the review, evaluation and management of drug therapy to a patient, being treated by a physician for a specific disease or associated disease states, in accordance with...Shift work
$120k - $150k
...next generation pharmacy benefits manager, overseeing prescription... ...Capital Rx is seeking a self-driven pharmacist with operating and leadership experience in utilization management review across all... ...in coverage determination and appeals reviews and audits. ~ Experience...Work at officeLocal areaRemote workShift workWeekend work$140k - $150k
A healthcare management company is seeking a licensed pediatric pharmacist for a remote position based in the United States. The role entails conducting medication reviews, providing consultations to caregivers, and ensuring accurate documentation. Ideal candidates will...Remote job$124k - $204.7k
Memorial Sloan Kettering Cancer Center (MSK) is seeking a Senior Application Analyst (Pharmacist) to ensure safety and efficiency in medication management within the Epic system. Responsibilities include managing Epic builds, collaborating with clinical teams, and supporting...$140k - $150k
A leading pediatric healthcare provider is seeking a licensed pediatric pharmacist to join their remote team. This role involves optimizing medication management for high-risk pediatric patients, collaborating with healthcare providers and caregivers. Candidates should...Remote job$60 - $70 per hour
...actively recruiting several clinical Pharmacists to support a leading national health... ...for pharmacy drug authorizations and appeals . This fully remote opportunity allows... ...to support pharmacy operations and utilization management. Qualifications Doctor of Pharmacy...Contract workTemporary workRemote workFlexible hoursShift workWeekend work$140k - $150k
...Perfecting Peds Perfecting Peds is long‑term comprehensive medication management, as an analytically driven and interoperable virtual... ...seeking a highly skilled and motivated New York licensed pediatric pharmacist to join our team in providing comprehensive medication...Remote jobLocal areaFlexible hours$55 per hour
...Summary Performs prospective and/or retrospective drug utilization review and appeals per State and Federal regulations. Participates in the distribution... .... May participate in formulary development and management. Supports the National Pharmacy and Therapeutics...Contract workRemote workWork from home- ...Lead, Nuclear Pharmacist Memorial Sloan Kettering Cancer Center is hiring for a Lead, Nuclear Pharmacist Position in Murray Hill, New... ...medications for various applications in MITS. - Provide management of nuclear pharmacy operations and staff, project management,...
$127.04k - $190.57k
...made personal. Clinical Pharmacy Manager – Internal Medicine / Transitions of Care... ...Identify, design and analyze drug utilization reviews to promote rational drug therapy... ...residency preferred. Current New York State Pharmacist License – New York State Department of...Full timeLocal areaWeekend workAfternoon shift$30k
...and maintain comprehensive drug therapy management programs which optimize patient... ...staff and workflow processes. Provide pharmacist services as required. Responsibilities... ...Provides oversight for appropriate medication utilization; identifies factors driving utilization...Full timePart timeRelocation packageShift work$60 - $76 per hour
A healthcare provider in Georgia is seeking a District Support Pharmacist. The role requires managing patient health through dispensing, counseling, and immunizing practices. The ideal candidate will hold an active pharmacist license and possess strong customer service...Hourly payFull time- JobRx, Inc. is seeking a Clinical Pharmacist in Georgia who will oversee pharmaceutical care and provide effective patient education on medication therapy. The ideal candidate will have a Bachelor's or Doctorate degree in pharmacy, be licensed in Georgia, and possess strong...Full time
- ...federal services consulting firm is seeking a National Program Manager (NPM) to lead the Enterprise Drug File Adoption initiative for... ...Candidates must possess a pharmacy degree and an unrestricted pharmacist license, along with experience in clinical informatics. Strong...Remote work
$60 - $76 per hour
1930 CVS Rx Services, Inc. is seeking a part-time District Support Pharmacist to help manage pharmacist scheduling gaps across the district. This role involves overseeing pharmacy operations and ensuring compassionate patient care. The ideal candidate will hold an Active...Hourly payPart time$55 per hour
...solutions to federally qualified health centers around consulting and management of in-house & contract pharmacies and meeting their compliance... ...job entails a high level of responsibility and knowledge. A pharmacist does not merely hand out prescribed medicine; he/she has the...Hourly payContract workReliefImmediate startRelocation$60 - $76 per hour
1930 CVS Rx Services, Inc. is hiring a District Support Pharmacist to enhance patient care by overseeing pharmacy operations. In this role, you'll manage pharmacist shifts, ensure safe medication dispensing, and deliver exceptional patient service. A valid Pharmacist License...Hourly payShift work
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