- Molina Healthcare (Fort Worth, TX)
- …group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . * Assumes ... health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more
- CVS Health (Austin, TX)
- … Benefits Verification Department, and to provide direction to the staff within Pharmacy operations to ensure to ensure patient benefits are verified in ... supervisory experience in a related environment **Preferred Qualifications** + Specialty pharmacy experience. + Bachelor's Degree within Business, Management or… more
- Health Care Service Corporation (Richardson, TX)
- …Summary** This position leads all Medical Drug efforts within Enterprise Pharmacy . It sets strategic direction for Medical Drug reimbursement, oversees development ... understanding of health plan reimbursement and of the overall pharmacy value chain. It is skilled at data analysis,...be part of an organization committed to offering meaningful benefits to our employees to support their life outside… more
- Cardinal Health (Austin, TX)
- …customer service and enrollment activities as well as Reimbursement Staff performing benefit investigations for pharmacy and medical benefit coverage. ... Cardinal Health Sonexus Health Pharmacy Services helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain… more
- Sharecare (Austin, TX)
- …parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex pharmacy inquiries + Complex spending ... from members (via voice and chat) for the following: + Help with eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card… more
- Highmark Health (Austin, TX)
- …and financial analysis capability for Highmark's pharmacy and medical benefit specialty drug management programs. Furthermore, the incumbent will utilize ... The role involves executing all facets of the Informatics project management process, leading multiple project managers, and potentially guiding, mentoring, or… more
- Prime Therapeutics (Austin, TX)
- …decision making with the client, or Prime leadership + Work directly with account management to optimize the pharmacy spend through adoption and expanded use of ... at times, lead client-facing initiatives; provide input into, and client management support for initiatives such as implementations, setting performance standards,… more
- Molina Healthcare (Austin, TX)
- … management , network contracting and provider relations, member services, claims management , payment integrity, pharmacy , quality and risk adjustment. * Acts ... a national business segment (ie Medicare, Marketplace, advanced imaging/central utilization management services) in the development and execution of care … more
- HCA Healthcare (Conroe, TX)
- …not limited to; pharmacokinetics, anticoagulation dosing, IV to PO, pain management , antimicrobial stewardship, and pharmacy -directed dosing + Reviews/interprets ... your application for the opportunity below:Clinical PharmacistHCA Houston Healthcare Conroe ** Benefits ** HCA Houston Healthcare Conroe offers a total rewards package… more
- HCA Healthcare (Kingwood, TX)
- …not limited to; pharmacokinetics, anticoagulation dosing, IV to PO, pain management , antimicrobial stewardship, and pharmacy -directed dosing + Reviews/interprets ... career as a(an) Clinical Pharmacist today with HCA Houston Healthcare Kingwood. ** Benefits ** HCA Houston Healthcare Kingwood, offers a total rewards package that… more