Remote Health Plan Pharmacist - Medicare/Medicaid Formulary
ROLE
Role, Inc. is seeking an experienced pharmacist for a remote position within the state of Arizona. The candidate will manage and support the Medicare and/or Medicaid formulary, providing essential clinical and economic data for formulary decisions while ensuring compliance with regulatory standards. The role requires at least 5 years of pharmacy experience and a Pharm.D degree, along with active Arizona pharmacist licensure. Excellent communication and problem-solving skills are essential. #J-18808-Ljbffr
- ...Shield of Arizona is seeking a pharmacist to support the Medicare and/or Medicaid formulary while providing clinical and economic... ...for decision-making. This remote position requires residency in... ...interfacing with network physicians and health plan members, designing educational...Remote workHealth Insurance
$126.3k - $173.7k
...impact on Humana's Medicaid plans... ...Partners with pharmacists, data scientists,... ...developing Humana formulary strategy to mitigate... ...trend and improve health outcomes. Contributes... ...Knowledge of Medicare/Medicaid as it relates... ...While this is a remote position, occasional...Remote workHealth InsuranceBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hours$107.7k - $199.3k
...Medical Management/Health Services team.... ...flexibility. This is a remote position, Hours... ...and custom formularies for all lines of... ...including Commercial, Medicaid, Medicare Part D and the... ...Current state's Pharmacist license with no restrictions... ...stock purchase plans, tuition...Remote workHealth InsuranceFull timePart timeWork at officeFlexible hours$50 - $55 per hour
...entity owned by 20 non-profit health plans serving 33 million members... ...government programs including Medicare and Medicaid. JOB OVERVIEW Location: Work from home (100% remote) - refer list of states... ...authorization services for formulary drugs, develops programs to...Remote workHealth InsuranceContract workWork from home$50 - $55 per hour
...entity owned by 20 non-profit health plans serving 33 million members... ...government programs including Medicare and Medicaid, seeks an accomplished Pharmacist – 100% Remote - California Residents Only!!... ...prior-authorization services for formulary drugs, develops programs to...Remote workHealth InsuranceContract workTemporary workLocal areaWork from homeHome officeMonday to FridayShift work- ...mission to inspire health and make it easy. AZ... ...as hybrid, onsite or remote. While the majority... ...and supporting the Medicare and/or Medicaid formulary and providing clinical... ...physicians, health plan members, medical services... ...as a practicing pharmacist ~3 years of experience...Remote workHealth InsuranceWork experience placementWork at officeFlexible hoursShift work1 day per week
- ...centralized Population Health Management (PHM... ...with pharmacists and the broader... ...primary focus on Medicare Advantage populations... ...Advantage, Medicaid, Commercial)... ...authorization follow-up, formulary alternatives,... ...Skills Health Plan / Medicare... ...hours. Remote with occasional...Remote workHealth InsuranceFull timeWork at officeRelocation packageMonday to Friday
$19.81 - $28.3 per hour
...Primarily support Medicare Advantage Star... ...and under pharmacist guidance. Support... ...Medicare Advantage, Medicaid, Commercial)... ...follow‑up, formulary alternatives, refill... ...and population health priorities.... ...Skills Health Plan / Medicare Advantage... ...hours. Remote with occasional...Remote workHealth InsuranceHourly payFull timeWork at officeRelocation packageMonday to FridayShift work- ...Shift First (Days) Overview: Sentara Health Plans is hiring for a Clinical Pharmacist for Medicare STARS - Remote! Status: Full-time,permanent position (40... ...Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network...Remote workHealth InsurancePermanent employmentFull timeTemporary workRelocationShift work
$118.88k - $139.31k
...Clinical Strategy Pharmacist page is loaded## Clinical... ...evolving LucyRx’s formulary and drug strategy to... ...in PBM, managed care, health plan, or related pharmacy... ...regulated populations (e.g., Medicare, Medicaid) preferred* Ability... ...in a fast-paced, remote-first environment with...Remote workHealth InsuranceWork at officeHome office- ...The Clinical Pharmacist is responsible for... ...effective, and accurate formulary by providing... ...to address Medicare Part D associated... ...Exchanges) and Health Insurance Plan Rankings • Identify... ...of Medicare & Medicaid Services (CMS)... ...Thursday ) and remotely 2 days a week (Monday...Remote workHealth InsuranceWork at officeMonday to Friday2 days per week3 days per week
$123.25k - $208k
...building a world of health around every... ...position is 100% remote and can be located... ...Summary The Health Plan Clinical Advisor... ...pharmacy support team, pharmacists, medical... ...particular client (Medicare, Medicaid, Exchange, or Commercial... ...and custom formulary options and utilization...Remote workHealth InsuranceHourly payFull timeTemporary workLocal areaWork from home- ...Drug Utilization Review Pharmacist - Ensure Safe and Effective Use... ...against clinical guidelines and formulary criteria. Identify... ...compliance with state, federal, and health plan requirements.... ...roles offer hybrid or fully remote schedules. Rewards: Competitive...Remote workHealth Insurance
- ...Sentara Health Plans is hiring a Clinical Pharmacist for Medicare STARS, a remote position based in Norfolk, VA. The ideal candidate will possess a Bachelor's degree in Pharmacy and a valid pharmacist license, with experience in Medicare STARS preferred. You'll work with...Remote workHealth InsuranceMonday to Friday
- ...public sector groups, health systems, and other payers... ...real value for plan sponsors on day one through... ...the Clinical Strategy Pharmacist, you will play a pivotal... ...effectiveness to inform formulary decisions. Monitor... ..., Life, 401k, Paid Time Off. Location: RemoteRemote workHealth Insurance
$20.19 - $28.37 per hour
...time to join the WellSense Health Plan, a growing regional... ...Investment in You Full‑time remote work Competitive... ...the administration of the formulary and benefits Provide pharmacy... ...New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997,...Remote workHealth InsuranceFull timeTemporary work- ...Description UPMC Health Plan has an exciting opportunity... .... This is a remote position working Monday... ...Registration as a registered pharmacist (RPh), in the... ...the management of the Formulary, Prior Authorization,... ...Commercial, Exchange, Medicare, Medicaid, Exchange, and/or CHIP...Remote jobHealth InsuranceMonday to Friday
$125k
...Remote Judi Health is an enterprise health technology company providing... ...for employers and health plans, including: Capital Rx , a... ...Summary The Clinical Care Pharmacist plays a vital role in promoting... ...Commercial, Exchange, Medicare, and Medicaid plans. Accurately document...Remote workHealth InsuranceTemporary workLocal areaWeekend work- ...dramatically improve the value of health care. We provide superior... ...The Trade Relations Formulary and Rebate Optimization Pharmacist is a client facing role... ...strategies to manage plan costs. ~ Models clinical... ...location (or from a remote location with management...Remote workContract workWork at officeMonday to FridayNight shiftWeekend work
$113.7k - $162.4k
...Preferred Drug List (PDL) Pharmacist Date: May 20, 2... ...PDL needs of the Medicaid Fee-for-Service... ...managing formularies from clinical, operational... ...and comply with Health Insurance... ...maintain project plans and agendas What... ...This position is remote Supports Gainwell...Remote workHealth InsuranceFull timeFlexible hours- ...looking for a Medical Billing Specialist. This fully remote position focuses on Medicare and Medicaid billing, requiring two years of experience in... ...effectively with Facilities. Benefits include a private health care plan, DailyPay options, life insurance, and training...Remote workHealth Insurance
- ...Pharmacist, Formulary Operations - Archimedes Location US- ID 2026-6127 Category Archimedes Position Type Full-Time Remote Yes Company Archimedes About Us Archimedes - Transforming the Specialty Drug...Remote workFull timeWork at office
$96.71k
...opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how... ...include contract oversight, formulary management, pharmacy benefit... ...and current unrestricted NY state Pharmacist license are required. Doctorate...Health InsuranceFull timeContract workPart timeFlexible hours$41.74 - $62.68 per hour
...Pharmacist-Utah State Hospital Are you ready to dispense... ...$62.68 Hourly Wage Remote Work / In-Office - In-... ..., implement or reform Medicaid policy. Prepares... ...files, and inventories. Plans, implement, or maintain... ...and your family. Health Insurance: Multiple medical...Remote workHealth InsuranceHourly payFull timeWork at office$96.71k - $116.06k
...opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how... ...include contract oversight, formulary management, pharmacy benefit... ...and current unrestricted NY state Pharmacist license are required. Doctorate...Health InsuranceFull timeContract workPart timeWork at officeFlexible hours- ...building the future of health insurance with a first-... ...its-kind employer-based plan designed to remove... ...other HCPCS codes. The pharmacist will perform prior authorization... ..., provider education, formulary management, Pharmacy &... ...needs. This is a REMOTE Position with RPh Licensure...Remote workHealth InsuranceFull timeMonday to FridayFlexible hours
- ...will perform general Pharmacist duties, including but... ...department Follows all Medicare, Medicaid, HIPAA, and Private... ...lines of communication Plans and organizes work... ...the smart choice for health plans, providers, employers... ...-Life Balance: Remote or hybrid work options...Remote workHealth InsuranceWork at officeFlexible hours
- ...You Will Have The clinical pharmacist is responsible for supporting... ...will collaborate closely with Medicaid, Medicare and Commercial associates from the health plan, and the pharmacy benefit manager... ...week you are empowered to work remote. Compensation and Benefits...Remote workHealth InsuranceFor contractorsWork at officeLocal area2 days per week
- ...a Medical Billing Specialist to work fully remote. This full-time position focuses on timely billing for Medicare, Medicaid, and Insurance. Candidates must have at least... ...significant benefits including a Private Health Care Plan and DailyPay options, fostering a supportive...Remote workHealth InsuranceFull time
$132.54k - $161.44k
...limited duration) Remote Employment:... ...0 Department: Health Care Authority... ...Behavioral Health Pharmacist (CP/CQCT) - Project... ...based care across Medicaid and other public programs... ...stakeholders, providers, plans, and delivery... ...Security and Medicare systems. The state...Remote workHealth InsuranceFull timePart timeWork experience placementWork at officeImmediate startFlexible hoursShift work
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