• Pharmacist , Utilization

    Molina Healthcare (West Valley City, UT)
    Molina Healthcare is hiring for a remote Pharmacist in our Utilization Management department. This role is 100% remote. The Pharmacist , UM will ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assist leadership team in understanding quality and cost-control issues… more
    Molina Healthcare (12/24/25)
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  • Clinical Pharmacist

    Point32Health (Canton, MA)
    …. **Job Summary** Under the direction of the Pharmacy Utilization Management ( UM ) Supervisor, the Clinical Pharmacist is responsible for ... issues with pharmacy technicians and confer with other clinical pharmacist on review questions + Communicate with UM... pharmacist on review questions + Communicate with UM staff and providers when issues arise regarding policy… more
    Point32Health (12/20/25)
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  • Senior Manager - Clinical Development…

    CVS Health (Pittsburgh, PA)
    …will be responsible for overseeing the development, maintenance, and execution of utilization management programs. This will include both the clinical content ... needed to ensure the programs are implemented correctly. Knowledge of utilization management interventions including prior authorization, step therapy, quantity… more
    CVS Health (11/24/25)
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  • Senior Clinical Pharmacist , Oncology…

    Premera Blue Cross (Mountlake Terrace, WA)
    …as part of a core team. You'll collaborate cross-functionally with care management , utilization management , provider/member relations, and market-facing ... through our Healthsource blog: https://healthsource.premera.com/ . The **Senior Clinical Pharmacist ,** **Oncology Program** will lead and help develop Premera's… more
    Premera Blue Cross (11/05/25)
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  • Clinical Pharmacy Specialist, Pharmacy Benefits…

    Northwell Health (New Hyde Park, NY)
    …responsible for the development, implementation, and maintenance of drug formularies, clinical utilization management ( UM ) criteria, and evidence-based drug ... findings. + Performs all duties of a licensed registered Pharmacist as required by the leadership and as identified...in formulary management , P&T committee support, and/or utilization management (PA, ST, QL) criteria development… more
    Northwell Health (12/23/25)
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  • Case Manager, Maternity (RN or LMSW)

    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 (11/26/25)
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