- Molina Healthcare (Yonkers, NY)
- … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... patient outcomes, medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist , UM will be responsible for reviewing coverage… more
- Molina Healthcare (Yonkers, NY)
- …and quality initiatives under the direction of leadership. * Monitors drug utilization and assists leadership team in understanding quality and cost-control issues ... pharmacy benefit changes for the upcoming year. * Works with the care management department as part of a member-centered interdisciplinary care team (ICT). * Works… more
- CVS Health (NY)
- …long-term vision and strategy around Part B drug management related to utilization management ( UM ), clinical programs, and pharmacy operations. + Lead ... every day. As the Senior Manager, Aetna Medicare Medical Pharmacist , you will play a key role in the...B and specialty drugs. Key areas of responsibility include utilization management , clinical programs, and operational excellence.… more
- CVS Health (NY)
- …+ Consulting with and recommending standard and custom formulary options and utilization management edits. + Collaborating with internal partners to develop ... drives lowest net cost. + Consulting with and recommending utilization management programs or other clinical programs...Advisor will consult with and advise the Clinical Benefits Pharmacist , and or other members of the Benefits and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more