Medicare Clinical Pharmacist - Prior Auth & CMS Expert
JobRx, Inc.
JobRx, Inc. in Detroit, MI seeks a licensed Pharmacist to oversee Medicare pharmacy operations with on-site weekly requirement. The role involves collaboration with PBM teams, handling prior authorizations, and applying CMS regulations and clinical coverage criteria to patient care. Ideal candidates bring Doctor of Pharmacy, strong communication, teamwork, and proficiency with Microsoft Office and proprietary systems to support a fast-paced environment. #J-18808-Ljbffr JobRx, Inc.
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Medicare Clinical Pharmacist - Prior Auth & CMS Expert in Detroit, MI vacancy
$70 - $71 per hour
EPITEC is seeking a Remote Clinical Pharmacist - Prior Authorization Reviewer to support Medicare pharmacy operations from Detroit, MI, with occasional in‑office days.... ...role handles prior authorization requests, applies CMS rules, and collaborates with providers and...CmsRemote jobHourly payWork at officeMonday to Friday- Kyyba is seeking a pharmacist to support PBM operations, focusing on prior authorization, CMS regulatory alignment, and efficient task management. The role expects collaboration with diverse teams in a fast-paced setting. Schedule includes Monday-Friday 9:00-5:30 with...CmsMonday to Friday
- Dept: Medicare Pharmacy Clini Will this position be required to work onsite for any... .... Top 3 Required Skills/Experience Prior authorization experience in a PBM environment... ...Demonstrated experience using clinical resources, e.g., CMS regulations and clinical coverage...CmsWork at officeMonday to Friday1 day per week
$70 - $71 per hour
Remote Clinical Pharmacist - Prior Authorization Reviewer (Medicare Pharmacy) Location: Detroit, MI, Remote (may require 1 day a week in office) Job Type: W2 Schedule... ...for evaluating medication coverage requests using CMS regulations, clinical coverage criteria, and...CmsHourly payWork at officeRemote workMonday to Friday1 day per week- Kyyba seeks a Clinical Pharmacist in Detroit, MI for a 12+ month hybrid role. The position requires prior authorization experience in a PBM environment, strong CMS/regulatory knowledge, and the ability to juggle multiple urgent tasks with accuracy. Doctor of Pharmacy is...CmsMonday to Friday
- ...combined with career development. Job Title Clinical Pharmacist Location Detroit, MI 48226 (Hybrid)... ...Required Skills/Experience (Top 3) Prior authorization experience in a PBM environment... ...using clinical resources, e.g., CMS regulations and clinical coverage criteria...CmsWork at officeMonday to Friday1 day per week
- JobRx, Inc. in Detroit, Michigan is seeking a pharmacist to provide clinical pharmacy services. The role includes reviewing prescriptions, counseling patients, and supervising support personnel to ensure high-quality patient care. Responsibilities also involve conducting...
- JobRx, Inc. is seeking a qualified pharmacist in Detroit, Michigan, to provide clinical pharmacy services and drug information to healthcare providers. The role involves reviewing prescriptions, filling medications, and counseling patients, while ensuring compliance with...
- Corewell Health Dearborn Hospital seeks a dedicated Inpatient Pharmacy Pharmacist for a full-time rotating shift. You will provide pharmaceutical care, collaborate with care teams, and support medication management across inpatient services. Candidates must have a Pharm...Full timeRotating shift
- A leading IT consulting firm is seeking a Sitecore Developer with at least 3 years of experience in Sitecore CMS projects. The ideal candidate will have strong technical knowledge of Sitecore, ASP.NET C#, and web development. Duties include developing multi-lingual websites...Cms
- Henry Ford Health is seeking a Pediatric/PICU Clinical Pharmacy Specialist at St John Children’s Hospital in Detroit, Michigan. This role... ...in pediatrics. Certification from the Michigan Board of Pharmacy is required prior to hire. #J-18808-Ljbffr Henry Ford Health
- ...Commission as a primary stroke center. The hospital is also known for clinical excellence and innovation in the fields of orthopedics,... ...experience pharmacy experience Preferred ~ LIC-Clinical Pharmacist - STATE_MI State of Michigan 90 Days required ~ LIC-Pharmacist...Part timeShift workRotating shiftWeekend work
Corewell Health
Dearborn, MI4 days ago - ...status Job Summary Under limited supervision, provides clinical pharmacy services including primary care services,... ...completion of foreign equivalency examination. 2. Registered Pharmacist and Controlled Substance licensures in the State of Michigan obtained...Full timeFlexible hoursRotating shift
DMC Harper University/Hutzel Women's Hospital
Detroit, MI1 day ago - ...Disposition Form Assessment for Medicare patients per Tenet policy ·... ...by the healthcare team prior to discharge (10% daily, essential... ...procedures to comply with the CMS Conditions of Participation and... ...pediatric burn center. Experts in pediatric critical care, rehabilitation...CmsFull timeWork at officeLocal areaFlexible hoursShift work
DMC Sinai-Grace Hospital
Detroit, MI4 days ago - Location: Detroit, MI (onsite). The Cyber Expert is a lead subject matter expert responsible for driving cybersecurity strategy, advanced... ...audiences Certifications such as CISSP, CISM, or equivalent Prior experience as: Cyber Advisor Cyber SME Security Architect...Local area
- ...management, and operational audit excellence within a highly regulated Medicare Advantage environment. Key responsibilities include leading SOX... ...accounting firm is required, along with a strong command of CMS regulations, PCAOB standards, SEC reporting, and COSO frameworks...Cms
Confidential
Detroit, MI2 days ago - SUMMARY:The Clinical Pharmacist assumes responsibility for the day to day comprehensive, customer oriented clinical pharmacy services provided... ...policies and procedures to ensure compliance with Medicare Part D regulations.Implements various processes to improve safety...
- A healthcare provider is seeking a Pharmacist - Clinical at DMC Harper University Hospital in Detroit, Michigan. The role involves providing clinical pharmacy services, reviewing and dispensing medications, and supervising support staff. The ideal candidate will be a State...Full time
- ...the nation. Job Summary Under limited supervision, provides clinical pharmacy services including primary care services, consultative... ...completion of foreign equivalency examination. 2. Registered Pharmacist and Controlled Substance licensures in the State of Michigan...Full time
- A healthcare organization in Southfield, MI is seeking an experienced Clinical Pharmacist to manage comprehensive clinical pharmacy services. The role focuses on optimizing drug therapy for elderly participants, collaborating with interdisciplinary teams, and ensuring compliance...
- A leading healthcare provider in Michigan is seeking a Clinical Pharmacist to deliver high-quality pharmacy services. You will review prescriptions, counsel patients, and collaborate with healthcare professionals to ensure optimal patient care. Ideal candidates have a PharmD...
- Henry Ford Health System is seeking a Pediatric/PICU Clinical Pharmacy Specialist to join the St. Johns Children's Hospital team. In this full-time role, you will optimize pediatric patients’ medication management while collaborating closely with multidisciplinary teams...Full time
- PACE Southeast Michigan is seeking a Clinical Pharmacist to provide day-to-day clinical pharmacy services, med utilization oversight, and project... ...optimize drug therapy for elderly participants and ensure Medicare Part D compliance. The Pharmacist will lead education...
- ProCare Rx in Southfield, MI seeks a clinical professional to evaluate and improve pharmacy programs. You will analyze data, advise clients, and participate in quality control initiatives. The ideal candidate will have a Bachelor's degree in pharmacy, advanced education...
- Tenet Healthcare is hiring a Clinical Pharmacist for DMC Sinai-Grace Hospital in Detroit, Michigan. This full-time role involves providing comprehensive clinical pharmacy services, ensuring the safe use of medications, and offering patient education across various clinical...Full timeRotating shift
$23 - $28 per hour
...care management activities in compliance with CMS guidelines for CCM and PCM billing • Identify... ...panel, and meet program compliance targets • Prior experience in a value-based care, care management, or outpatient/clinic setting preferred Benefits: • Health insurance...CmsHourly payRemote workFlexible hoursEndogen Wellness
Dearborn, MIa month ago- ...and retain current members. Responsibilities include marketing, account management, and training agents while ensuring compliance with CMS guidelines. Ideal candidates will possess a Bachelor's degree, a valid Michigan insurance license, and at least three years of sales...Cms
$22 per hour
...Candidates should have 2-4 years of experience in Specialty and/or Retail Pharmacy, effective communication skills, and be a High School Graduate. Join a dynamic team supporting Medicare Part B drug coverage inquiries and prior authorizations. #J-18808-Ljbffr TekWissen ®Remote jobTemporary work- ...products experience preferred. Certification/Licences Required Registered Nurse credentialed from the Michigan Board of Nursing obtained prior to hire date or job transfer date required. BLS Provider preferred. American Heart Association accepted. Case Manager credentialed...CmsPart timeShift work
$103k - $155k
...care. Candidates must possess an active RN or LCSW/LMSW license and prior acute care hospital case management leadership experience. Key... ...of care, and medical necessity compliance Monitor compliance with CMS regulations, accreditation standards, and internal case...CmsFull timeRelocation packageWheeler Staffing Partners
Detroit, MI1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicare Clinical Pharmacist - Prior Auth & CMS Expert. Be the first to apply!
Related searches
- hospital pharmacist Detroit, MI
- clinical pharmacist Detroit, MI
- fulfillment expert Detroit, MI
- technology expert Detroit, MI
- guest service support expert Detroit, MI
- cms Detroit, MI
- medicare analyst Detroit, MI
- medicare Detroit, MI
- nurse practitioner - medicare assessments Detroit, MI
- medicare medical director Detroit, MI