- The Cigna Group (Bloomfield, CT)
- …customers. He/she will serve as a clinical educator and consultant to utilization management , case management , network, contracting, pharmacy , and service ... health care administration. **Major responsibilities and required results:** + Performs benefit -driven medical necessity reviews for coverage, case management ,… 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
- Elevance Health (Denver, CO)
- …of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits . By leveraging the power of new technologies, our strong, ... clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry. **Build the Possibilities. Make an Extraordinary… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …to ensure deadlines are met. Works in conjunction with the Pharmacy Benefit Manager (PBM) and Formulary Management software vendor to execute on all ... all Medicare Part D formulary creation and submissions, which includes utilization management criteria development for the current and upcoming contract years. This… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …where associates want to work and help communities thrive. **Clinical Pharmacy Specialist - Anderson Hospital** **Job Summary:** This role delivers patient ... and coordinate the care provided by health team members. The Clinical Pharmacy Specialist participates in clinical programs and initiatives >90% of the time… more
- Sharecare (Albany, NY)
- …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
- CenterWell (Trenton, NJ)
- …one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing ... our caring community and help us put health first** The Workforce Management Professional 1 applies and integrates advanced and predictive analysis, people metrics… more
- AmeriHealth Caritas (Newtown Square, PA)
- …those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health ... a strategic thinker with a deep understanding of creative project management methodology, exceptional organizational skills, and the ability to navigate uncertainty.… more
- Rush University Medical Center (Chicago, IL)
- …and maintain the Willow application to support clinical workflows, enhance medication management , and streamline pharmacy processes. You'll work closely with ... AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits ...role where your work directly impacts patient care and pharmacy operations. At Rush, you'll be part of a… more
- University of Michigan (Ann Arbor, MI)
- …System Safety Drills + Chemical Inventory + Supervision of Red Bag and formulary management + Liaison for Pharmacy + Liaison for Health Department + Liaison ... and become a victor for the greater good. **What Benefits can you Look Forward to?** + Excellent medical,...for Lab + Responsible for personnel management and workflow of Medical Assistants to ensure optimal… more