- Molina Healthcare (Buffalo, 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …which include Medicare, Commercial, Exchange (Marketplace) and Medicaid. The focus of the UM Pharmacist is to manage the quality, appropriateness, safety and ... is required. + Managed care experience is strongly preferred, especially experience in utilization management . In lieu of managed care experience, proven record… more
- CVS Health (Albany, NY)
- …Senior Manager in Medical Affairs and is responsible for clinical drug list, formulary, and utilization management ( UM ) analyses, with a focus on MHP. The ... environment + 2 to 3 years demonstrated experience in formulary development and pharmacy utilization management + Deep, broad knowledge of drug and disease state… 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
- 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