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Pharmacist jobs at Blue Shield of California

- 44 jobs
  • Pharmacist, Principal

    Blue Shield of California 4.7company rating

    Pharmacist job at Blue Shield of California

    Your Role The Pharmacy Markets, Products, Analytics and Strategies (RxMAPS) team is responsible for leading and collaborating cross-functionally with key stakeholders across Pharmacy Strategy and Operations and Blue Shield. The RxMAPS team drives analytic strategy and performs clinical and business analyses necessary to provide consultations and strategic program recommendations to improve Cost of Health Care (COHC) and optimize outcomes. The Principal Pharmacist, Cost of Health Care will report to the Senior Manager, Rx Data Information Oversight and Reporting. In this role you will play a key role in leading and collaborating cross-functionally with key stakeholders across Blue Shield to drive analytic strategies and perform clinical and business analyses to improve COHC and optimize outcomes. You will monitor pharmacy and medical drug trends and the drug pipeline, and work with Actuarial and Finance teams to explain drivers of trend and identify opportunities for trend management. You will work with Enterprise Analytics to track and forecast COHC savings from pharmacy initiatives. Your Knowledge and Experience Requires a Doctor of Pharmacy (PharmD) degree Requires a currently active and unrestricted California Registered Pharmacist (RPh) license Requires at least 4 years of experience in clinical pharmacy Requires at least 3 years of experience in pharmacy benefit management and managed care health plan working with large pharmacy and medical claims datasets Experience with other pharmacy data (e.g., pharmacy and medical rebates, pharmacy networks, prior authorization) is preferred Requires proficient data analytic skills with Microsoft Office (e.g., Excel and Access) and other data analytic tools (e.g., SQL, SAS, Snowflake, Tableau) Requires ability to leverage business and clinical knowledge to interpret health plan benefit utilization and pharmacy financial data and derive actionable recommendations for COHC savings initiatives Requires understanding of pharmacy data parameters available for analysis Requires ability to work independently with minimal oversight and direction from the manager Requires ability to work collaboratively with multi-disciplinary and cross functional teams Requires excellent presentation, verbal, and written skills with ability to understand and convey complex ideas to an audience with diverse backgrounds Requires the ability to work in a fast-paced environment with a "can do" attitude and solution-oriented approach to resolve challenges Your Work In this role, you will: Analyze and monitor prescription drug claims, medical drug claims, and program data to identify opportunities to improve quality and cost of healthcare Serve as a BSC Pharmacy Strategy and Operations contact and subject matter expert to stakeholders, and manage external relationships (vendors, clients) related to assigned work Proactively monitor pharmacy trends (e.g., brand and generic drug pipeline, new legislation and regulatory requirements, COHC initiatives) Provide pharmacy trend driver variance explanation (e.g., utilization, drug mix, unit cost) Present findings on drug pipeline, COHC initiative savings, and other drivers of trend to help drive COHC initiative ideation and strategy with cross-functional stakeholders Support Enterprise Analytics in developing COHC savings methodology and reporting to estimate, track, and forecast COHC initiative savings Work with Actuarial teams to enable accurate pharmacy pricing and trend forecast for quarterly Trendsetter processes Participate in lines of business finance and performance review meetings to understand and/or provide input on business drivers and objectives Work cross-functionally to support and drive on-time submission of select state and federally mandated reports Respond to trend surveys, request for proposals, and other data analytic requests
    $150k-185k yearly est. Auto-Apply 46d ago
  • Fulfillment Pharmacist- Greensboro, NC (Accredo)

    Cigna 4.6company rating

    Greensboro, NC jobs

    This role is onsite at our office in Greensboro, NC on Gallimore Dairy Road. We are located very close to the airport. The Staff Pharmacist is responsible for verifying and dispensing medications within corporate and regulatory guidelines. The Staff Pharmacist will track order status. The Staff Pharmacist may also train less experienced pharmacists. This position will require product verification and the ability to be flexible. Hours of operation may include on call, evenings, and weekends, mainly Monday-Friday 8:00 am- 5:00 pm. ESSENTIAL FUNCTIONS Provide oversight and quality assurance to pharmacy technicians. Interpret physicians' or prescribers' prescriptions. Verify and confirm validity of controlled substances. Verify prescription information entered in the system by data entry or order entry. Back up other pharmacists as needed, perform additional duties as assigned by management, or train less experienced pharmacists. QUALIFICATIONS Current resident pharmacist license in good standing. Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues. Good oral and written communication skills. Ability to read and interpret prescriptions. Strong focus on customer service, quality and accuracy. Ability to manage timelines and meet tight client deadlines. Ability to adapt in a changing environment. Ability to work a flexible schedule for peak volume times. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
    $108k-134k yearly est. 9d ago
  • Fulfillment Pharmacist- Greensboro, NC (Accredo)

    The Cigna Group 4.6company rating

    Greensboro, NC jobs

    **This role is onsite at our office in Greensboro, NC on Gallimore Dairy Road. We are located very close to the airport.** The Staff Pharmacist is responsible for verifying and dispensing medications within corporate and regulatory guidelines. The Staff Pharmacist will track order status. The Staff Pharmacist may also train less experienced pharmacists. This position will require product verification and the ability to be flexible. Hours of operation may include on call, evenings, and weekends, mainly Monday-Friday 8:00 am- 5:00 pm. **ESSENTIAL FUNCTIONS** + Provide oversight and quality assurance to pharmacy technicians. + Interpret physicians' or prescribers' prescriptions. + Verify and confirm validity of controlled substances. + Verify prescription information entered in the system by data entry or order entry. + Back up other pharmacists as needed, perform additional duties as assigned by management, or train less experienced pharmacists. **QUALIFICATIONS** + Current resident pharmacist license in good standing. + Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues. + Good oral and written communication skills. + Ability to read and interpret prescriptions. + Strong focus on customer service, quality and accuracy. + Ability to manage timelines and meet tight client deadlines. + Ability to adapt in a changing environment. + Ability to work a flexible schedule for peak volume times. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. **About Evernorth Health Services** Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. _Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._ _If you require reasonable accommodation in completing the online application process, please email:_ _*********************_ _for support. Do not email_ _*********************_ _for an update on your application or to provide your resume as you will not receive a response._ _The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._ _Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._
    $108k-134k yearly est. 40d ago
  • Staff Pharmacist - Scottsdale, AZ

    Cigna 4.6company rating

    Scottsdale, AZ jobs

    This position is onsite in Scottsdale, AZ. Hours are Monday-Friday from 8:30AM-5PM AZ with a Saturday rotation. This position also comes with an on-call rotation for 7 days. The Staff Pharmacist is responsible for the supervision, and coordination of all activities in the Pharmacy Fulfillment area and the education of patients to administer these medications appropriately. The pharmacist provides direct oversight and supervision of the pharmacy technicians and pharmacy interns in their duties and responsibilities to receive prescriptions, process prescriptions, dispense drugs and proper shipping and delivery of medications. The pharmacist assures oversight and safety of pharmacy operations. Essential Functions Interpret, review, and adjudicate prescriptions Prepare and dispense appropriate medications to patients Check prescriptions for accuracy Provide medication therapy review; assess the appropriateness of the medication in accordance to patient's medical history Contact prescribing physicians to discuss questions regarding prescriptions, coordination and continuity of treatment Provide information and advice regarding drug interactions, side effects, dosage and proper medication storage so patients can use their medications safely and effectively Provide personal counseling and education to the patient Comply with state and federal laws pertaining to prescription preparation and dispensing Help with policy development, - i.e., procedures for improved work flow Ensure maintenance of stock and storing and proper handling of medications Maintain records, such as pharmacy files, patient profiles, control records for narcotics, and controlled drugs Review interactions and contraindications of reported use of over the counter medications. Provide emotional support to patient and partner during infertility treatment, and provide information on reputable support and advocacy groups when appropriate. Ensure patient confidentially and HIPAA adherence Based on operational needs the Pharmacist may be assigned to other function as required Complies with FDA mandates and self-imposed manufacturer restrictions on particular drugs, as applicable Qualifications B.S. Pharmacy or PharmD Degree required Experience working in a pharmacy setting preferred Must have an active Arizona pharmacist license in good standing. Additional state licenses a plus. Must have the ability to make clinical decisions Must be compassionate, courteous and have excellent interpersonal skills Must have the ability to read, analyze and interpret common scientific and technical journals Ability to work a flexible work schedule Detail oriented with ability to handle multiple tasks with frequent interruption Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions Conduct work in compliance with office workplace polices Actively participates in the achievement of patient satisfaction If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
    $114k-143k yearly est. Auto-Apply 13d ago
  • Clinical Pharmacy Technician Sr - Remote

    Prime Therapeutics 4.8company rating

    Madison, WI jobs

    At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Clinical Pharmacy Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. **Responsibilities** + Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists. + Escalates requests to Pharmacist when request requires extensive clinical review or denial. + Monitors telephone system to ensure adequate staffing to maintain client services levels. + Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices. + Demonstrates, advocates and reinforces a positive team environment. + Other duties as assigned. **Minimum Qualifications** + Education Level + GED + High School + Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy + 2+ years Pharmacy Must be eligible to work in the United States without the need for work visa or residency sponsorship **Additional Qualifications** + Must have an active pharmacy technician licensure or registration in accordance with state requirements. + If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT). + In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT). + Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting. + In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.). + Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite. + Excellent written and verbal communication skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted. + Ability to identify and trouble-shoot problematic issues. **Preferred Qualifications** Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (******************************************* and click on the "Benefits at a glance" button for more detail. _Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to_ _race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law._ _ _ _We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._ _Prime Therapeutics LLC is a Tobacco-Free Workplace employer._ Positions will be posted for a minimum of five consecutive workdays. At Prime Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference. We know that people make all the difference. If you're ready for a purpose-driven career and are passionate about simplifying health care, let's build the future of pharmacy together. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at ************** or email *****************************.
    $19.2-28.9 hourly 60d+ ago
  • Clinical Pharmacy Technician Sr - Remote

    Prime Therapeutics 4.8company rating

    Phoenix, AZ jobs

    At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Clinical Pharmacy Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. **Responsibilities** + Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists. + Escalates requests to Pharmacist when request requires extensive clinical review or denial. + Monitors telephone system to ensure adequate staffing to maintain client services levels. + Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices. + Demonstrates, advocates and reinforces a positive team environment. + Other duties as assigned. **Minimum Qualifications** + Education Level + GED + High School + Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy + 2+ years Pharmacy Must be eligible to work in the United States without the need for work visa or residency sponsorship **Additional Qualifications** + Must have an active pharmacy technician licensure or registration in accordance with state requirements. + If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT). + In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT). + Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting. + In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.). + Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite. + Excellent written and verbal communication skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted. + Ability to identify and trouble-shoot problematic issues. **Preferred Qualifications** Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (******************************************* and click on the "Benefits at a glance" button for more detail. _Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to_ _race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law._ _ _ _We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._ _Prime Therapeutics LLC is a Tobacco-Free Workplace employer._ Positions will be posted for a minimum of five consecutive workdays. At Prime Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference. We know that people make all the difference. If you're ready for a purpose-driven career and are passionate about simplifying health care, let's build the future of pharmacy together. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at ************** or email *****************************.
    $19.2-28.9 hourly 60d+ ago
  • Clinical Pharmacy Technician Sr - Remote

    Prime Therapeutics 4.8company rating

    Raleigh, NC jobs

    At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Clinical Pharmacy Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. **Responsibilities** + Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists. + Escalates requests to Pharmacist when request requires extensive clinical review or denial. + Monitors telephone system to ensure adequate staffing to maintain client services levels. + Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices. + Demonstrates, advocates and reinforces a positive team environment. + Other duties as assigned. **Minimum Qualifications** + Education Level + GED + High School + Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy + 2+ years Pharmacy Must be eligible to work in the United States without the need for work visa or residency sponsorship **Additional Qualifications** + Must have an active pharmacy technician licensure or registration in accordance with state requirements. + If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT). + In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT). + Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting. + In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.). + Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite. + Excellent written and verbal communication skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted. + Ability to identify and trouble-shoot problematic issues. **Preferred Qualifications** Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (******************************************* and click on the "Benefits at a glance" button for more detail. _Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to_ _race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law._ _ _ _We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._ _Prime Therapeutics LLC is a Tobacco-Free Workplace employer._ Positions will be posted for a minimum of five consecutive workdays. At Prime Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference. We know that people make all the difference. If you're ready for a purpose-driven career and are passionate about simplifying health care, let's build the future of pharmacy together. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at ************** or email *****************************.
    $19.2-28.9 hourly 60d+ ago
  • Clinical Pharmacist

    Western Health Advantage 4.3company rating

    Sacramento, CA jobs

    Summary Description: Clinical Pharmacists function in many areas within the pharmacy department. Clinical Pharmacists perform the clinical review of medical and outpatient pharmacy Utilization Management (UM) cases, using their clinical acumen and benefit information into consideration when issuing a decision. Clinical Pharmacists are charged with adhering to all regulations in their decision making, including NCQA, DMHC and Board of Pharmacy. Provide timely coverage determinations for drug prior authorizations (PA), exception requests, and appeals utilizing posted drug criteria, clinical guidelines, and creditable drug information resources. They need to communicate effectively with network providers and staff, discussing member prior authorizations and decision rationale. Clinical Pharmacists are responsible for formulary development activities for multiple lines of business including leading internal Pharmacy and Therapeutics Committee (P&T) efforts, in addition to serving as members on this committee. Efforts include drug pipeline management, recommendations, monograph creation, and policy writing while maintaining and updating pharmacy UM policies. They provide clinical oversight for the accuracy of claims adjudication, as needed. Clinical Pharmacists manage new-to-market products, National Drug Codes (NDCs), and communication with the PBM's Clinical Consultant. Clinical Pharmacists support the management and updates of the preferred drug list. Clinical Pharmacists support implementation of clinical programs, revision of drug policies and guidelines and completion of therapeutic category reviews. Clinical Pharmacists also provide recommendations on process improvement to department leadership. Representative Duties: • Develop and update clinical pharmacy UM criteria for review of both outpatient pharmacy and office administered medications. • Monitor and review prior authorization (PA) requests for medications; perform all duties related to drug utilization review in compliance with regulatory requirements. • Research drug information to maintain current, accurate drug knowledge and disease state understanding for application to PA reviews. • Analyze pharmacy cost of care, trends, and coordinate the development of appropriate use protocols, programs, and guidelines. • Provide support to the P&T Committee through committee participation and project completion, including therapeutic category reviews, drug reviews, criteria updates, record keeping, and other analyses, as needed. • Participate in the development and implementation of clinical quality improvement programs in coordination with the Medical Management department, Pharmacy Benefit Management (PBM), and Medical Groups. • Interface with Medical Groups and Prescribers to educate and inform them of pharmacy program initiatives and cost-effective prescribing options, as needed. • Work closely with the PBM to support coding and management of newly released or existing drug products identified through the P&T committee and routine audits of formulary documents. • Audit and update the WHA formulary drug list and Pharmacy PA Criteria website. • Precept or participate with pharmacy students on their introductory or advanced pharmacy practice experience rotations with affiliated pharmacy schools, as needed. • Assist the Pharmacy Manager with accreditation audits by the Department of Managed Health Care (DMHC) regulatory and National Committee of Quality Assurance (NCQA), as needed. • Provide clinical guidance and support to various internal departments that require clinical pharmacist intervention. • Support development of pharmacy policy procedures, training material, and desk level procedures. • Work with the Pharmacy Manager to ensure there is appropriate coverage during holidays and Friday night to ensure all cases are completed to comply with regulatory requirements • Perform other duties and special projects as assigned by the Chief Pharmacy Officer and Pharmacy Manager. Qualifications: • Must have a Doctor of Pharmacy (PharmD) degree or equivalent education that satisfies California pharmacist license requirements. Pharmacy Residency training is preferred. • Must have a current, valid California Pharmacist license in good standing and must be maintained throughout employment. • Four years of mail order, retail, or hospital experience. • Two years of managed care pharmacy experience, PBM, Health Plan, or delegated Medical Group is preferred. • Proficient in the evaluation of drug literature, clinical trial data, and electronic database information (e.g., UpToDate, DrugDex, Clinical Pharmacology, NCCN, etc.). • Strong clinical and analytical background for specialty medications is preferred. • Experience writing drug monographs or prior authorization criteria. • Formulary management experience is preferred. • Experience writing with business correspondence style. • Proficient computer skills, including electronic mail, routine database activity, word processing, spreadsheet, graphics, etc. • Must be able to speak, read, write, and understand the primary language(s) used in the workplace Salary: $118,000.00 - $140,000.00 annually (EOE) Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law. Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you - and excellent customer service for our members. *WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Please be advised that Western Health Advantage will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams' option.'
    $118k-140k yearly Auto-Apply 60d ago
  • Pharmacist Utilization Management

    Network Health 4.4company rating

    Brookfield, WI jobs

    The Pharmacist Utilization Management oversees the administration of the pharmacy department's utilization management program for both traditional pharmacy and infusion-related medications. This individual provides clinical support for other departments quality and health management efforts. This role assists in the development and evaluation of the plan formulary and benefit designs. Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model. Hours: 1.0 FTE, 40 hours per week, 7:30am - 5pm Monday through Friday Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team. Job Responsibilities: * Administrative/Operational Support * Compliance Regulatory * Professional Collaboration Support * Quality Outcomes (including Medicare Stars, NCQA, HEDIS) * Support and administer vendor oversight audits * Participate in case management, disease management and poly-pharmacy for Network Health patients with extraordinary high drug costs * Collaborate with formulary management team in development of utilization management criteria for Plan drug benefits including incorporating rebate optimization, branch logic, automation, and machine learning where appropriate. * Assist with operational oversight of Medicare Part D Fraud, Waste & Abuse Program and other government programs * Pharmacy benefit utilization and prior authorization real-time surveillance * Assist in tracking the introduction of generic drugs/biosimilars to the marketplace and develops focused projects/programs to maximize the cost-saving potential of these drugs and reduce costs in specific drug categories of the Plan formulary * Perform retrospective reviews/audits on claims and prior authorizations for appropriateness * Assist Sales, Member Experience, Providers, Brokers, and Community Partners with Pharmacy Benefit questions * Assist in tracking the introduction of new drugs to the marketplace and advises the Pharmacy and Therapeutics (P&T) Committee on formulary decisions. * Other duties and responsibilities as assigned. Job Requirements: * Bachelor of Science in Pharmacy required * Current licensure without restriction by the State of Wisconsin Pharmacy Examining Board required * A minimum of 3 years clinical experience required * Residency/fellowship preferred * Managed care experience desirable * Drivers license required Network Health is an Equal Opportunity Employer
    $120k-147k yearly est. 6d ago
  • Director of Pharmacy Operations

    M3 Insurance 3.9company rating

    Madison, WI jobs

    The Opportunity Are you looking for a rewarding leadership role as a Director of Pharmacy Operations? Are you ready to propel your career into the dynamic world of pharmacy benefit management and consulting? If you're passionate about leading high-performing teams, have extensive PBM industry expertise, and enjoy driving operational excellence, this is the opportunity for you. In this role, you'll be instrumental in leading our client management team while ensuring exceptional delivery of prescription drug benefit consulting services. Beyond just managing operations, you'll develop meaningful professional relationships with PBM partners and clients, drive strategic initiatives, and contribute directly to our clients' pharmacy benefit success. You'll leverage your extensive pharmacy industry knowledge in a collaborative environment where your leadership and expertise are recognized and valued, with opportunities to shape the future of our pharmacy consulting services. How You Will Make an Impact Lead operational functions of the client management team by managing internal resources and delegating work effectively to deliver exceptional pharmacy consulting services. Directly supervise and develop Ethica's client service team, coaching and mentoring team members in prescription drug benefit knowledge, PBM contract expertise, and client relationship management. Build and maintain strong strategic relationships with PBM partners and pharmacy benefit vendors, overseeing contract negotiations and service level expectations. Partner with the Chief Pharmacy Officer to develop and implement comprehensive strategic plans for Ethica's client management function. Own and continuously enhance the Client Experience within Ethica, ensuring consistent delivery of pharmacy consulting value and seamless PBM relationship management. Monitor revenue flow and reconciliation in partnership with internal Finance team and PBM partners. Develop and implement policies and procedures across all Firm solutions and oversee quality assurance for pharmacy contract negotiations, RFP processes, and audit delivery. Facilitate recruitment, onboarding, and retention of pharmacy consulting talent with appropriate industry experience. What You Will Need to Succeed Bachelor's degree in business, healthcare administration, or equivalent combination of education and experience required. Minimum of eight years of management or supervisory experience in the PBM, managed care pharmacy, or pharmacy consulting industry preferred. Demonstrated knowledge of pharmacy language, drivers of pharmacy costs, and PBM contracts with comprehensive understanding of the current PBM and pharmacy industry trends. Proven track record in client relationship management and team leadership with experience in direct supervision of team members across multiple pharmacy consulting roles. Project Management or Operations certificates preferred. Professional verbal and written communication skills with the ability to interact effectively with internal and external clients, PBM partners, and carriers. Strong organizational and planning skills with excellent time management abilities and attention to detail. Demonstrated proficiency in Microsoft Windows-based software applications, including Word, Excel, and PowerPoint. Ability to work accurately and effectively with agency automation systems (EPIC). Flexibility and positive attitude toward learning with active learner mindset and curiosity for growth. Team player mentality with collaborative approach and willingness to support organizational goals. Join Us Your role at Ethica won't be about the boundaries presented in a job description - it's about the possibilities that you can envision once you walk through the doors on your first day. We're looking for people ready to take control of their career and excited to make a real impact with their position. Who We Are As a specialized pharmacy consulting firm, Ethica Pharmacy Advisors helps you optimize prescription drug benefits, manage pharmacy costs, and navigate the complex PBM landscape. We partner with clients on everything from PBM contract negotiations and pharmacy benefit audits to strategic planning and cost management solutions. We're committed to delivering exceptional client outcomes through our expertise in pharmacy benefit management and consulting. What Draws People to M3 Autonomy - Being able to work towards a common goal, but how you get there is an open book. Immediate Impact - Every team member can make an impact, from day one in any role. Powered by Team - Be a part of a close-knit group of team members with whom you build trust and share responsibility. People - Every team member is unique in their own way, Ethica is a collection of unique achievers. At Ethica Pharmacy Advisors experience the best of both worlds with our dynamic flexible work environment. Enjoy the flexibility to work remotely while still fostering collaboration and innovation in our office spaces. We prioritize work-life balance and empower our employees to thrive in a supportive and inclusive atmosphere. Benefits Joining the Ethica team means gaining access to a host of exceptional benefits and perks. Our benefits package is continuously evolving to cater to the needs of our team members. From flexible time-off and professional development opportunities to employee appreciation events and volunteering opportunities, we prioritize the well-being and satisfaction of our employees. These enticing benefits showcase our commitment to nurturing and retaining top talent within our organization. Diversity, Equity & Inclusion Equal Employment Opportunity Ethica is committed to providing equal employment opportunity for all qualified individuals regardless of their age, sex, color, race, creed, national origin or ancestry, religion, marital status, military status, sexual orientation, disability/handicap, family responsibilities, non-relevant arrest or conviction records, or any other basis protected by law. In addition, we are committed to fully observing all relevant non-discrimination laws, including those regarding veterans' status, and will make reasonable accommodations for otherwise qualified individuals as appropriate. This commitment is reflected in all Ethica's practices and policies regarding hiring, training, promotions, transfers, rates of pay, and layoff, as well as in all forms of compensation, granting leaves of absence and in any other conditions of employment. All matters relating to employment are based upon ability to perform the job. In the best interests of Ethica and all of its employees, every employee is to make every effort to avoid bias or prejudice in the workplace with regard to the above categories.
    $34k-51k yearly est. 60d+ ago
  • Pharmacist Utilization Management

    Network Health 4.4company rating

    Menasha, WI jobs

    The Pharmacist Utilization Management oversees the administration of the pharmacy department's utilization management program for both traditional pharmacy and infusion-related medications. This individual provides clinical support for other departments quality and health management efforts. This role assists in the development and evaluation of the plan formulary and benefit designs. Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model. Hours: 1.0 FTE, 40 hours per week, 7:30am - 5pm Monday through Friday Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team. Job Responsibilities: * Administrative/Operational Support * Compliance Regulatory * Professional Collaboration Support * Quality Outcomes (including Medicare Stars, NCQA, HEDIS) * Support and administer vendor oversight audits * Participate in case management, disease management and poly-pharmacy for Network Health patients with extraordinary high drug costs * Collaborate with formulary management team in development of utilization management criteria for Plan drug benefits including incorporating rebate optimization, branch logic, automation, and machine learning where appropriate. * Assist with operational oversight of Medicare Part D Fraud, Waste & Abuse Program and other government programs * Pharmacy benefit utilization and prior authorization real-time surveillance * Assist in tracking the introduction of generic drugs/biosimilars to the marketplace and develops focused projects/programs to maximize the cost-saving potential of these drugs and reduce costs in specific drug categories of the Plan formulary * Perform retrospective reviews/audits on claims and prior authorizations for appropriateness * Assist Sales, Member Experience, Providers, Brokers, and Community Partners with Pharmacy Benefit questions * Assist in tracking the introduction of new drugs to the marketplace and advises the Pharmacy and Therapeutics (P&T) Committee on formulary decisions. * Other duties and responsibilities as assigned. Job Requirements: * Bachelor of Science in Pharmacy required * Current licensure without restriction by the State of Wisconsin Pharmacy Examining Board required * A minimum of 3 years clinical experience required * Residency/fellowship preferred * Managed care experience desirable * Drivers license required Network Health is an Equal Opportunity Employer
    $119k-146k yearly est. 6d ago
  • Corporate Traveling Pharmacist - Remote

    Unitedhealth Group 4.6company rating

    Phoenix, AZ jobs

    **Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** As a per diem, nonexempt, Traveling Corporate Pharmacist with our CPS Advance team, you will be deployed from your home to various client sites throughout the designated state(s) to as-needed assignments that will vary in length from a few days to a few weeks or even month. You'll work with other pharmacists and hospital healthcare professionals to provide pharmacy services that meet the highest standards of the profession. You'll fill orders with accuracy; check technician-prepared products before release; maintain security of pharmacy and controlled substances; enter orders and patient information with accuracy; aid in the training of new staff; update the Director about the daily activities of the pharmacy; and aid the Director in maintaining the pharmacy. Schedule: This position has no regularly scheduled hours and works as needed to cover shifts at various facilities, which may include reimbursable/paid travel. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Assist current client hospital clients as needed + Assist with set up of new clients + Ability to travel nationwide as needed You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + BS or Pharm D from an ACPE-accredited School of Pharmacy + 1 active Pharmacist license in good standing (preference for one of the following states: IN, MI, MN, CA, OH, WV, PA, AZ) + Willingness to obtain additional state Pharmacist licenses + 2+ years of recent hospital pharmacy work experience as a Pharmacist (which may include an ASHP pharmacy residency program) + Experience in IV admixtures, unit dose drug distribution and computer order entry + Very good drug knowledge base including pharmacokinetics dosing and nutritional support + Valid driver's license and ability to pass company Motor Vehicle (MVR) background check + Ability to travel by car or airplane, sometimes on short notice + Willing to travel for all assignments *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $43.22 to $77.21 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $43.2-77.2 hourly 38d ago
  • Pharmacy Regulatory Manager

    Medica 4.7company rating

    Madison, WI jobs

    Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm, and every member feels valued. The Pharmacy Regulatory Manager oversees contractual and regulatory requirements necessary to service Medica's contracts with the Department of Human Services. Includes communication of requirements with affected areas within Medica and vendors by monitoring their activities and through thorough documentation of implementation and compliance activities in accordance with the standards of the Compliance Operations department. Completes all DHS and CMS filings. Serves as Medica's first contact to DHS. Performs other duties assigned. Required Qualifications: * Bachelor's degree or equivalent experience in related field * 5 years of applicable work experience beyond degree including compliance and regulatory experience * 5+ years experience with compliance and regulatory environments This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN or Madison, WI. The full salary grade for this position is $61,500 - $105,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $61,500 - $92,190. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
    $61.5k-105.4k yearly 45d ago
  • Staff Pharmacist

    Unitedhealth Group Inc. 4.6company rating

    Redding, CA jobs

    Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. As a Staff Pharmacist you'll play a vital role in delivering safe, accurate, and efficient pharmacy services. This is a hands-on opportunity to make a direct impact by ensuring the accuracy of medication orders, verifying technician-prepared products, and safeguarding controlled substances. You'll contribute to a high-performing team by mentoring new staff, maintaining seamless daily operations, and supporting the Director in optimizing pharmacy performance. Pharmacy Location: Located at Banner Lassen Medical Center in Susanville, CA Schedule: This full time, nonexempt position will work every other weekend on Saturday, 7:00am-3:30pm, and Sunday, 7:00am-11:00am, with on call immediately following each shift This position will also work 3-4 8-hour dayshifts each week from 7:00am-3:30pm with on call immediately following the shift. Pharmacy Hours: Monday-Saturday, 7:00am-3:30pm, and Sunday 7:00am-11:00am. After hours is supported by Remote Order Entry. The Pharmacy utilizes Cerner and Pyxis automation, EMAR and BVM. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * ACPE-accredited pharmacy degree (PharmD preferred) * Active applicable state pharmacist license in good standing * 1+ years of recent pharmacist experience, (hospital setting preferred) * Proven skilled with pharmacy systems and Microsoft Office Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $43.22 to $77.21 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $43.2-77.2 hourly 60d+ ago
  • Staff Pharmacist

    Unitedhealth Group 4.6company rating

    Chico, CA jobs

    **Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** As a **Staff Pharmacist** you'll play a vital role in delivering safe, accurate, and efficient pharmacy services. This is a hands-on opportunity to make a direct impact by ensuring the accuracy of medication orders, verifying technician-prepared products, and safeguarding controlled substances. You'll contribute to a high-performing team by mentoring new staff, maintaining seamless daily operations, and supporting the Director in optimizing pharmacy performance. **Pharmacy Location:** Located at Banner Lassen Medical Center in Susanville, CA **Schedule:** This full time, nonexempt position will work every other weekend on Saturday, 7:00am-3:30pm, and Sunday, 7:00am-11:00am, with on call immediately following each shift This position will also work 3-4 8-hour dayshifts each week from 7:00am-3:30pm with on call immediately following the shift. **Pharmacy Hours:** Monday-Saturday, 7:00am-3:30pm, and Sunday 7:00am-11:00am. After hours is supported by Remote Order Entry. The Pharmacy utilizes Cerner and Pyxis automation, EMAR and BVM. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + ACPE-accredited pharmacy degree (PharmD preferred) + Active applicable state pharmacist license in good standing + 1+ years of recent pharmacist experience, (hospital setting preferred) + Proven skilled with pharmacy systems and Microsoft Office Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $43.22 to $77.21 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $43.2-77.2 hourly 60d ago
  • Home Infusion Pharmacist

    Unitedhealth Group 4.6company rating

    Phoenix, AZ jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** What makes your pharmacy career greater with OptumRx? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. As a pharmacist on the Clinical and Pharmacy Operations team, you will perform various duties as it relates to therapy assessment, care planning and departmental communications to streamline efficiencies across the department. To succeed in this position, a baseline understanding of various infusion related therapies is needed. These functions include interpreting, formulating, and dispensing of infusion and/or specialty drugs for sterile compounding and/or distribution. Pharmacist clinical activities include therapy assessment, care planning, and medication reconciliation as they pertain to individual patients and the appropriate monitoring for effective care and positive patient outcome. This is a dynamic work environment and requires flexibility to meet business needs and adaptability to frequent changes. Teamwork is the norm and all employees will be held accountable to work as effective team members. This position is for a Clinical and/or a Production Pharmacist working in the Optum Specialty Infusion Services unit within OptumRx, a UnitedHealth Group company. **Must be available to work an 8 hour shift between the hours of 7 am - 7 pm.** **Primary Responsibilities:** + Reviews medication orders and evaluates appropriateness and completeness of orders with consideration given to the special needs and behaviors of the specific age group served + Verifies all prescriptions not directly received from the prescriber or physician's agent + Provides oversight of the safety, appropriateness, and effectiveness of the pharmaceutical care provide to patients (consumers) as it relates to specialty products dispensed + Assesses the patient at the initiation of drug therapy, develops a patient care plan and drug monitoring regimen, and monitors the patient according to the care plan throughout the course of therapy + Communicates with the patient, physician, nursing staff, other pharmacists, and other members of the health care team regarding patient status, response to therapy, and clinical objectives to ensure clinical outcomes are met + When required, compounds intravenous and specialty pharmaceuticals in an aseptic fashion according to established State Board of Pharmacy, Federal, USP sterile guidelines and company policy + Knowledgeable of the proper use and handling of both sterile and hazardous medications; Compounds and handles sterile and hazardous medications in accordance with established guidelines and regulations + Ensures compliance with all FDA, DEA, State Board of Pharmacy, OSHA, and other regulatory standards; Follows all department policies and procedures + Provides indirect oversight of pharmacy technician and pharmacy support staff You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + BS in Pharmacy or Pharm D degree + Pharmacist license in good standing in the state of Arizona, or the ability to obtain within 30 days + 1+ years of experience working as a licensed Pharmacist in a hospital, home infusion setting, or related healthcare environment + Solid drug product and clinical pharmacy knowledge + Knowledgeable in various infusion related therapies with ability to work through the complexity of therapy related orders + Demonstrated ability to fill medication orders accurately and in a timely manner + Demonstrated ability to navigate MS Office and a Windows based environment and able to create, edit, save, and send documents utilizing Microsoft Word; Ability to navigate Outlook and conduct Internet searches + Demonstrated ability to work a flexible schedule and rotate being on call based on business needs **Preferred Qualifications:** + Nutritionally Certified + Home Care or Home Infusion experience + Sterile compounding experience + CPR+ software experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $43.22 to $77.21 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $43.2-77.2 hourly 5d ago
  • Clinical Pharmacist

    Unitedhealth Group Inc. 4.6company rating

    Tucson, AZ jobs

    For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. OptumCare Network of Arizona is a network of local doctors, hospitals, and specialists that help patients make well-informed decisions about their healthcare. The Clinical Pharmacy Team provides a variety of clinical services impacting Medical Management and CMS Stars Quality initiatives. The Clinical Pharmacist will be overseeing initiatives to improve medication adherence, assist with Medication Therapy Management, medication reconciliations post-discharge, and various retrospective drug utilization reviews for network providers per business needs. The team comprises of clinical pharmacists and certified pharmacy technicians that complete various functions to successfully meet the operational requirements of each clinical service. The work hours required will be during normal business hours, Monday through Friday. The Clinical Pharmacist will report to the Clinical Pharmacy Manager. This role is primarily responsible for performing medication reconciliations post-discharge and improving transitions of care. In addition, the clinical pharmacist will perform office visits with patients according to a collaborative practice. The Clinical Pharmacist will be responsible for managing and overseeing therapy for patient for a variety of chronic conditions; including but not limited to diabetes hypertension, hyperlipidemia, COPD, asthma, insomnia, obesity, smoking cessation, anticoagulation, and chronic pain. Primary Responsibilities: * Manage and oversee therapy for patient for a variety of chronic conditions; including but not limited to diabetes hypertension, hyperlipidemia, COPD, asthma, insomnia, obesity, smoking cessation, anticoagulation, and chronic pain as part of a collaborative practice * Utilize prescription and medical claim data to generate clinical recommendations according to Medication Therapy Management and Retrospective Drug Utilization Review program protocols * Provide clinical recommendations pertaining to, but not limited to, gaps in care, high risk medications, compliance and adherence, drug interactions, therapeutic substitution, and generic substitution * Utilize client formulary information to guide appropriate medication recommendations * Keep current with new and emerging clinical trends * Participate in departmental meetings to improve clinical programs and enhance processes * Share clinical information and department procedure protocols during client site visits * Assist with user acceptance testing for new clinical programs and system enhancements * Follow all policies and procedures related to job * Perform other duties as assigned to meet departmental objectives You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Bachelor's Degree in Pharmacy or higher * Current and unrestricted Pharmacist license in the state of Arizona * Solid customer service experience * Solid clinical pharmacy knowledge * Willing to work flexible hours in a fast paced environment * Demonstrated ability to work independently within a cross functional team environment * Demonstrated interpersonal, consultative, and problem - solving skills Preferred Qualifications: * Pharm.D. * Pharmacist Clinician * Certified Diabetes Educator * BPS board certification * Experience in managed care or health plan setting * Experience working as part of a collaborative practice. * Experience with STAR and HEDIS performance measures. * Proven intermediate level skill in Microsoft Word, Outlook, and Excel * Proven excellent verbal and written communication skills * Proven commitment to professionalism and a dedicated desire to advance patient care Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment
    $89.9k-160.6k yearly 60d+ ago
  • 2026 Ethica Summer Pharmacy Consulting Internship

    M3 Insurance 3.9company rating

    Wauwatosa, WI jobs

    The Opportunity Ethica Pharmacy Advisors, a M3 Connect Company, offers a unique and innovative opportunity for those individuals looking to blend their pharmaceutical interest with business consulting. Our Pharmacy Consulting Internship has the capacity to launch your long-term pharmacy career in a fast-paced and dynamic segment of the healthcare arena. Our internship will expose individuals with a focus on medicine or pharmacy to learn how employers make decisions and contract regarding benefit placement, formulary coverage, and clinical rules. In addition, the program provides insight into a stable and thriving industry while you build relationships with other interns, professionals, pharmacists, and leaders. How You Will Make an Impact Work side-by-side with consultants who specialize in pharmacy benefit consulting Research and learn the top medication drivers in the US that impact employers Use a variety of analytic tools to develop reports, dashboards, and complex data analysis Learn the complexities of PBM contracting and negotiations that drive savings for Plan Sponsors Become exposed to the variety of PBM vendors, and their differentiators, managing Rx benefits in the market today Be a key participant on projects that align with your interests and directly impact an employer's bottom line Collaborate with other interns and professionals to achieve the best outcome What You Will Need to Succeed High school diploma or equivalent is required. Pre-medicine or Pre-pharmacy curriculum is highly encouraged Actively enrolled Pharmacy Students (incoming PharmD P2 or P3 classes) are preferred Demonstrated success in college efforts through academics and/or involvement in activities. Experience working PowerPoint and Microsoft Excel. Strong critical thinking and problem solving abilities. Strong communication skills Strong project management skillset Join Us Your role at M3 won't be about the boundaries presented in a job description - it's about the possibilities that you can envision once you walk through the doors on your first day. We're looking for people ready to take control of their career and excited to make a real impact with their position. Who We Are As an insurance broker, M3 helps you manage risk, purchase insurance, and provide benefits to your employees. We partner with clients on everything from property & casualty and employee benefits to personal lines, executive benefits, and employer-sponsored retirement plans. And, we're privately owned and independent which means we're doing what's best for our clients - not what's best for Wall Street or private equity. What Draws People to M3 Autonomy- Being able to work towards a common goal, but how you get there is an open book. Immediate Impact- Every M3er can make an impact, from day one in any role. Powered by Team- Be a part of a close-knit group of team members with whom you build trust and share responsibility. People- Every M3er is unique in their own way, M3 is a collection of unique achievers. At M3 Insurance experience the best of both worlds with our dynamic flexible work environment. Enjoy the flexibility to work remotely while still fostering collaboration and innovation in our office spaces. We prioritize work-life balance and empower our employees to thrive in a supportive and inclusive atmosphere. Benefits as an M3er Joining the M3 team means gaining access to a host of exceptional benefits and perks. Our benefits package is continuously evolving to cater to the needs of our team members. From flexible time-off and paid parental leave to employee appreciation events and volunteering opportunities, we prioritize the well-being and satisfaction of our employees. Additionally, our profit-sharing program ensures that every member of our team shares in the success of our organization. These enticing benefits showcase our commitment to nurturing and retaining top talent within our organization. Diversity, Equity & Inclusion M3 is building a culture focused on learning and progression, where M3ers are empowered by education, inclusive conversations, and real action that supports the future we envision. Equal Employment Opportunity M3 is committed to providing equal employment opportunity for all qualified individuals regardless of their age, sex, color, race, creed, national origin or ancestry, religion, marital status, military status, sexual orientation, disability/handicap, family responsibilities, non-relevant arrest or conviction records, or any other basis protected by law. In addition, we are committed to fully observing all relevant non-discrimination laws, including those regarding veterans' status, and will make reasonable accommodations for otherwise qualified individuals as appropriate. This commitment is reflected in all M3's practices and policies regarding hiring, training, promotions, transfers, rates of pay, and layoff, as well as in all forms of compensation, granting leaves of absence and in any other conditions of employment. All matters relating to employment are based upon ability to perform the job. In the best interests of M3 and all of its employees, every employee is to make every effort to avoid bias or prejudice in the workplace with regard to the above categories.
    $44k-62k yearly est. 60d+ ago
  • Staff Pharmacist

    Unitedhealth Group Inc. 4.6company rating

    Gardena, CA jobs

    Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. As a full-time, non-exempt Staff Pharmacist you'll play a vital role in delivering safe, accurate, and efficient pharmacy services. This is a hands-on opportunity to make a direct impact by ensuring the accuracy of medication orders, verifying technician-prepared products, and safeguarding controlled substances. You'll contribute to a high-performing team by mentoring new staff, maintaining seamless daily operations, and supporting the Director in optimizing pharmacy performance. Location: Memorial Hospital of Gardena in Gardena, CA Schedule: This full time, nonexempt position will work up to 40 hours/week in a variety of day/evening/night shifts in this 24/7 centralized pharmacy. Pharmacy Hours: The centralized pharmacy is open 24/7 and supported by AllScripts and Pyxis. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * ACPE-accredited pharmacy degree (PharmD preferred) * Active applicable state pharmacist license in good standing * 1+ years of recent pharmacist experience, (hospital setting preferred) * Proven skilled with pharmacy systems and Microsoft Office Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $43.22 to $77.21 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $43.2-77.2 hourly 54d ago
  • Staff Pharmacist

    Unitedhealth Group 4.6company rating

    Gardena, CA jobs

    **Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** As a full-time, non-exempt **Staff Pharmacist** you'll play a vital role in delivering safe, accurate, and efficient pharmacy services. This is a hands-on opportunity to make a direct impact by ensuring the accuracy of medication orders, verifying technician-prepared products, and safeguarding controlled substances. You'll contribute to a high-performing team by mentoring new staff, maintaining seamless daily operations, and supporting the Director in optimizing pharmacy performance. **Location:** Memorial Hospital of Gardena in Gardena, CA **Schedule:** This full time, nonexempt position will work up to 40 hours/week in a variety of day/evening/night shifts in this 24/7 centralized pharmacy. **Pharmacy Hours:** The centralized pharmacy is open 24/7 and supported by AllScripts and Pyxis. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + ACPE-accredited pharmacy degree (PharmD preferred) + Active applicable state pharmacist license in good standing + 1+ years of recent pharmacist experience, (hospital setting preferred) + Proven skilled with pharmacy systems and Microsoft Office Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $43.22 to $77.21 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $43.2-77.2 hourly 53d ago

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