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Clinical Pharmacist jobs at Highmark - 26 jobs

  • Pharmacist - Utilization Management (UM) Remote

    Highmark 4.5company rating

    Clinical pharmacist job at Highmark

    Company :Highmark Inc. : This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION Required Bachelor's degree in Pharmacy Substitutions None Preferred Doctorate degree in Pharmacy EXPERIENCE Required 1 - 3 years in Pharmacy Preferred None LICENSES OR CERTIFICATIONS Required Registered Pharmacist Preferred None SKILLS Oral & Written Communication Skills General Computer Skills Problem Solving & Decision Making Compliance Prioritizing Language Requirement (other than English) None Travel Required None PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-Based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $67,500.00 Pay Range Maximum: $126,000.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice
    $67.5k-126k yearly Auto-Apply 2d ago
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  • Pharmacy Coordinator

    Highmark Health 4.5company rating

    Clinical pharmacist job at Highmark

    This job provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES** + Communicate effectively with physician and pharmacy network providers to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and timely manner. + Interact with staff to implement processes and problem solves. + Respond to drug benefit design inquires or exception requests and evaluate/direct daily workflow within the department. + Prioritize requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. + Recommend staffing adjustments necessary to appropriately maintain a level of high efficiency/productivity. + Ensure adherence to call center turn around time requirements associated with DPW/CMS regulations. + Take necessary steps to perform a complete and accurate evaluation of all non-formulary drug exception requests prior to approval, authorization or claim override. + Search member claim history profile and recommend formulary alternatives wherever feasible. + Contact physician network provider to obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document all authorizations and denials completely, accurately, and in accordance with timelines as defined by state and federal regulations to insure appropriate notification issuance to prescribing physician and impacted member. + Populate all authorization and denial information fields within the OnBase information system. + Enter all authorizations into the Argus IPNS information system to allow claim adjudication. + Complete other assigned duties as specified. + Identify and report improper coordination of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. + Other duties as assigned or requested. **QUALIFICATIONS:** **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of retail pharmacy and/or third party prescription procession + Strong background and understanding of medications and formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across multiple states. They must also be familiar with Medicare drug benefit design offerings that may differ by state, while being familiar with applicable federal rules/regulations that remain consistent throughout the nation **Skills** + Excellent computer skills such as working knowledge of Microsoft Outlook, Word, OnBase + Excellent interpersonal, communication and attentive listening skills + Strong organizational skills, detail oriented + Demonstrated excellence in communication skills + Demonstrated ability to work well with others + Demonstrated ability to work in a fast paced, multi-task environment **SCOPE OF RESPONSIBILITY** Does this role supervise/manage other employees? No **WORK ENVIRONMENT** Is Travel Required? No **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $19.01 **Pay Range Maximum:** $23.72 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273822
    $19-23.7 hourly 13d ago
  • Infusion Pharmacist

    Humana 4.8company rating

    Ohio jobs

    Become a part of our caring community and help us put health first The Pharmacist is a licensed professional who is responsible for the safe and appropriate dissemination of pharmacy services including medications and pertinent supplies. The Pharmacist also monitors the flow of activities in the pharmacy department including the processing of medication orders, sterile compounding preparation, order assembly, and inventory while ensuring proper documentation and compliance with all One Infusion policies and procedures, pharmacy practice professional standards (e.g., USP 797/800) and applicable regulatory agencies such as Accreditation Counsel for Home Care (ACHC). Duties and Responsibilities: Maintains a working knowledge of sterile IV admixtures, aseptic technique, and environmental monitoring in accordance with the guidelines set forth by USP 797/800. Determines, designs and monitors care plans that are unique and tailored specifically to the medical condition of the patient. Gathers all pertinent medical information from caregivers, case managers, physicians, and patients to determine suitability for home care services according to policies and procedures set forth by One Infusion Pharmacy as well as established pharmacy practice guidelines. Possesses a working knowledge of therapeutic drug levels and common laboratory values and is proficient in performing advanced pharmaceutical calculations. Monitors and trends lab values that are pertinent to a drug regimen and can make informed pharmaceutical recommendations and regimen adjustments to the ordering physician, nurse and/or patient based on established pharmacokinetic principles. Serves as the subject matter expert on all pharmacotherapy related matters and educates other One Infusion staff including nurses, pharmacy technicians as well as patients and caregivers. Monitors the activities of ancillary pharmacy personnel to quality and compliance with established pharmacy protocols and physician orders. Actively participates in continuity of care to and from home and other patient care settings. The pharmacist prepares and dispenses medications in a manner consistent with USP 797/800 as well as company policies and procedures. The pharmacist conducts quality control by inspecting the final preparation prior to delivery ensuring accuracy of concentration, quantity, stability, and labeling. Ensures ongoing compliance with all laws and regulations (e.g. DEA, BOP, ACHC,) so that the pharmacy meets or exceeds accreditation standards. Resolves pharmacy patient concerns and complaints and provides pharmacy patient counseling as needed. Monitors and reports medication errors, adverse drug reactions, allergies, and patient adherence issues, conducting patient profile monitoring as necessary. Collaborates with patients, caregivers, and healthcare professionals, communicating patient status and response to medication, as well as resolve patient issues, while documenting all interventions in a timely manner. Reports all misconduct, suspicious or unethical activities to the Compliance Officer and/or supervisor. Interact with pharmaceutical manufacturers' reps as needed to maintain current knowledge of pharmaceutical products and to manage changes to formulary. Monitors inventory levels to ensure adequate supplies, monitoring for market shortages and product recalls as well as maintaining perpetual inventory of controlled substances when required by company policy. Assumes on-call responsibilities in accordance with pharmacy guidelines and company policy and procedures. Reports product incidents as required in accordance with pharmacy policy and Performance Improvement Coordinator. Participate in the pharmacy's Performance Improvement program as requested by the Performance Improvement Coordinator. Participates in pharmacy committees, in-service education programs, and professional organizations as requested or directed by the Pharmacy Director. Completes continuing education programs as required for position duties and licensure requirements. Performs other duties as assigned by supervisor. Use your skills to make an impact Regulatory Requirements Graduate of an accredited School of Pharmacy Current, active pharmacist licensure (Pharm.D., RPH) in state of practice. Demonstrates sufficient knowledge of sterile IV admixture and is well versed In USP 797 and 800 guidelines. 1-2 years of clinical pharmacy experience in home care, hospital, or other infusion setting. Completion of an ASHP accredited Pharmacy Residency Program or an Advanced Pharmacy Practice Experience associated with an accredited school of pharmacy. 2+ years of clinical experience in home care, hospital, or other infusion settings Physical Requirements: Ability to participate in physical activity. Ability to lift and push up to fifty pounds without restriction. Ability to work for an extended period while standing and being involved in physical activity. Ability to do extensive bending, lifting, and standing on a regular basis. Language Skills: Able to communicate effectively in English, both verbally and in writing. Additional languages preferred. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $115.2k-158.4k yearly Auto-Apply 4d ago
  • Pharmacist (Specialty)

    Centene 4.5company rating

    Remote

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Pharmacist (Specialty) - Remote - MO, CA, TX or FL only Position Purpose: Coordinate and assist in managing and participating in pharmacy services, including dispensing of medications, quality assurance and clinical monitoring activities. Participate in decisions regarding the pharmaceutical services within assigned scope including: Assessing the patient's general pharmaceutical needs Planning for the pharmaceutical services provision Participating in the overall plan of care Participating in the overall quality assessment and improvement plan Receive physician prescription orders and evaluate the appropriateness of these orders for dosage, drug choice, potential drug interactions, route of administration and stability Supervise the filling, receiving, compounding, and dispensing activities involved in providing finished product to the patient Ensure that the patient chart is complete for allergies, height, weight, current and past medical history, clinical laboratory results and concurrent medications (including over-the-counter or home remedy medications) Ensure that when necessary, laboratory tests have been ordered and the results are obtained and discussed with the nurse and the physician Provide patient counseling, education, and monitoring Ensure safety of patients and personnel by exercising good pharmacy practice in the process of drug therapy instructions to the patient Determine remaining doses on hand to manage inventory and avoid waste Provide clinical interventions Assess responses to therapy, patient compliance, and ongoing review of drug regimens; report and manage adverse events Assist the physician, nurse and patient with clinical and technical support Document all communication with physicians, nurses and patients in the patient chart Assist in the maintenance and upkeep of all necessary paperwork required by state and federal agencies as well as the Joint Commission Assist the Pharmacy Manager in implementing new procedures Assist in the training and supervision of Pharmacy Technicians, Pharmacy Interns and other pharmacy personnel Participate in Performance Improvement Projects Assist in providing in-service programs to nursing and pharmacy personnel on any aspect of drug therapy Attend and/or complete education and training programs Review literature and other materials pertinent to the practice of pharmacy Complete all competency/skills assessment requirements Participate in on-call schedule Perform other tasks as determined by the Pharmacist-In-Charge Job Specific Details: Ensure patients receive the right medication, know how to use their medication, and address/resolve drug therapy issues prior to dispensing. Order entry Patient counseling Verification of prescription data entry, Performing drug utilization reviews Working with clinics to clarify and obtain prescriptions Excellent verbal and written communication Strong problem-solving abilities Analytical thinking, time management and organization skills, adaptable and collaborative mindset. Work location: Remote - MO, CA, TX or FL. Candidate will need to be licensed in their current state where we have a physical AcariaHealth location. Working shift: 8.5 Hour shifts / rotating shift within business hours 8 AM - 9 PM (EST / Eastern), includes a few closing shifts. Some holidays are required when business is open. Education/Experience: Bachelor's degree in pharmacy and 3+ years of mail order, retail or hospital pharmacy experience OR Pharm D. Licenses/Certifications: Current state's Pharmacist license and license at other states as required. You must be licensed in your home state and that home state must be MO, CA, TX or FL. Pay Range: $50.77 - $93.94 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $50.8-93.9 hourly Auto-Apply 12d ago
  • Pharmacy Resident

    Centene 4.5company rating

    Remote

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This is an American Society of Health-systems Pharmacies (ASHP) accredited PGY-1 residency position. To be considered, all candidates must also apply through the ASHP PhORCAS system to program 33013 by 01/02/2026. Selection for this position will follow ASHP Match rules and eligibility guidelines. ASHP Match - natmatch.com Position Purpose: A structured 1 year post-graduate education and training program designed to provide advanced knowledge and skills regarding drug therapy and pharmaceutical services in a managed care setting. Spends time rotating through the various areas within pharmacy, including Formulary Services, Pharmacy Operations, Medication Therapy Management (MTM), Appeals, Specialty Pharmacy, and Quality. Will be assigned specific activities, projects, and responsibilities. Completes Post-Graduate Year 1 (PGY-1) responsibilities of the residency program which includes annual rotation and cross department collaboration within the pharmacy department. Completes a residency project suitable for publication and present findings at the regional residency conference as well as an appropriate professional Centene meeting. Participate in formulary design and management, including participation in the Pharmacy and Therapeutics Committee. Evaluates pharmacy claims data for population-based disease management programs. Provides medication therapy management (MTM) services to the organization's members and collaborates with prescribers to ensure appropriate, evidence-based drug selection. Provides members and health care professionals with medication-related information and education. Participates in the prior authorization review and appeals processes. Participates in the organization's quality management and improvement activities Participates in clinical, humanistic, and economic outcomes analyses, including the drug utilization evaluation (DUE) process. Analyzes drug information literature and participate in journal club presentations. Provides clinical instruction to 4th year APPE rotation pharmacy students or by participating in a teaching certificate program offered by a local university. Performs other projects as assigned. Performs other duties as assigned Complies with all policies and standards Education/Experience: Pharmacy resident will obtain Doctor of Pharmacy (PharmD) from an ACPE-accredited college/school of pharmacy prior to start date. Exposure to managed care (student rotations acceptable), preferred. Licenses and Certifications: Licensed pharmacist by September 1st of residency year. For Fidelis: Candidate will work onsite at the NY location.Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $55.1k-99k yearly Auto-Apply 57d ago
  • Pharmacy Fellow - Health Equity and Systems Thinking

    Unitedhealth Group Inc. 4.6company rating

    Columbus, OH 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. The CPS Solutions, LLC Health Equity and Systems Thinking Pharmacy Fellowship is aimed to position our graduates to improve health equity through advocacy, recognition of systems thinking, and adoption of community resources/partnerships to improve chronic conditions. You will focus on addressing and improving healthcare disparities with the aim of a more culturally and competent pharmacist workforce in integrating social determinants of health screening and interventions into medication use encounters and improving patient outcomes. This is a 12-month position only. Additional time may be added as needed and will be determined by the end of the term. The Pharmacy Fellowship is a 12-month, full-time program starting in August 2026 with the schedule being a minimum of 40 hours per week, Monday - Friday, and occasional weekends as needed. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: * Analyze an assessment that incorporates structural and process of care indicators to improve health literacy and communication between pharmacy and patients during the medication management encounter * Collect and analyze patient population data for the health system or organization * Collaborate with departmental and/or interdisciplinary teams in the design, implementation, and/or enhancement of the organization's criteria for appropriate medication use management * Increase knowledge about social determinants of health (SDOH) and disparities in health care and explore attitudes and behaviors that promote and/or mitigate disparities in patient care * Conduct a longitudinal research and quality improvement project for presentation at a professional platform * Assess the health system (or department) for components of health literacy * Implement systems thinking-based evaluation design and intervention design * Evaluate opportunities for improving patient outcomes, clinical and operational efficiencies, safety and quality of the medication-use process through the application of Continuous Quality Improvement (CQI) strategies * Develop a structural Certificate Program in the area of health equity, disparity and systems thinking for preceptors and pharmacist leaders * Assist the organization in achieving compliance with accreditation, legal, regulatory, and safety requirements related to the use of medications (e.g., appropriate accrediting bodies and related professional organization standards, statements, and/or guidelines; state and federal laws regulating pharmacy practice) * Provide effective medication and practice-related education to health care professionals in health equity standards and systems thinking 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: * Minimum of a bachelor's degree from an American Council on Pharmaceutical Education (ACPE) accredited college or university (PharmD preferred) * Licensure in good standing as a Registered Pharmacist prior to the program start date; willingness to reciprocate * Post-graduate pharmacy residency (PGY1) or equivalent training * Must include curriculum vitae (CV), a personal letter of intent, transcript and the names and contact information of three individuals that can provide professional letters of recommendation as part of the application * Driver's License and access to reliable transportation Preferred Qualifications: * Doctor of Pharmacy (PharmD) * Degree in Public Health or work experience in public health services * Possess necessary knowledge to provide oversight of medication regimens for the patient populations treated in the facility, including a knowledge of dosing for specific age populations * Proven effective interpersonal and communication skills - verbal and written * Proficiency with pharmacy computer systems * Proficiency with Outlook, Word, PowerPoint and Excel * Ability to collaborate effectively with all levels across the organization. * 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 salary for this role will range from $71,200 to $127,200 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. 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.
    $71.2k-127.2k yearly 22d ago
  • Pharmacy Investigator - Remote in NY, NJ, PA

    Unitedhealth Group Inc. 4.6company rating

    New York, NY jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Investigator is responsible for identification, investigation and prevention of healthcare fraud, waste and abuse. The Investigator will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. The Investigator is responsible to conduct investigations which may include field work to perform interviews and obtain records and/or other relevant documentation. If you reside within the state of New Jersey, New York, and Pennsylvania, you will enjoy the flexibility to telecommute* as you take on some tough challenges. Applicants must be within commutable distance to Philadelphia, Kings, and Essex counties. Travel: Up to 50% Primary Responsibilities: * Assess complaints of alleged misconduct received within the Company * Investigate low to medium complex cases of fraud, waste and abuse * Detect fraudulent activity by members, providers, employees and other parties against the Company * Develop and deploy the most effective and efficient investigative strategy for each investigation * Maintain accurate, current and thorough case information in the Special Investigations Unit's (SIU's) case tracking system * Collect and secure documentation or evidence and prepare summaries of the findings * Participate in settlement negotiations and/or produce investigative materials in support of the latter * Collect, collate, analyze and interpret data relating to fraud, waste and abuse referrals * Ensure compliance of applicable federal/state regulations or contractual obligations * Report suspected fraud, waste and abuse to appropriate federal or state government regulators * Comply with goals, policies, procedures and strategic plans as delegated by SIU leadership * Collaborate with state/federal partners, at the discretion of SIU leadership, to include attendance at workgroups or regulatory meetings * Communicate effectively, including written and verbal forms of communication * Develop goals and objectives, track progress and adapt to changing priorities What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* 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 OR Associate's Degree * 2+ years of equivalent work experience with healthcare related employment * Basic level of proficiency in Microsoft Excel and Word * Ability to travel up to 50% within PA, NY, and NJ * Reside in PA, NY, or NJ - commutable distance to Philadelphia, Kings, and Essex counties * Ability to participate in legal proceedings, arbitration and depositions at the direction of management * Access to reliable transportation and valid US driver's license Preferred Qualifications: * License and/or Certified Pharmacy Technician (CPhT) * Accredited Health Care Fraud Investigator (AHFI) * Basic level of knowledge in health care policies, procedures and documentation standards * Basic level of skills in developing investigative strategies * Basic level of knowledge in pharmacy claims processing * Specialized knowledge/training in healthcare fraud, waste and abuse (FWA) investigations * Basic level of knowledge in analyzing data to identify FWA trends * Basic level of knowledge in state and federal regulatory FWA requirements * Active affiliations: * National Health Care Anti-Fraud Association (NHCAA) * Certified Fraud Examiner (CFE) * Operational experience with a pharmacy and/or pharmacy benefits manager (PBM) * All Telecommuters 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 salary for this role will range from $48,700 to $87,000 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. 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. #RPO #GREEN
    $48.7k-87k yearly 7d ago
  • Pharmacy Investigator - Remote in NY, NJ, PA

    Unitedhealth Group 4.6company rating

    New York, NY jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** The **Investigator** is responsible for identification, investigation and prevention of healthcare fraud, waste and abuse. The **Investigator** will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. The **Investigator** is responsible to conduct investigations which may include field work to perform interviews and obtain records and/or other relevant documentation. If you reside within the state of New Jersey, New York, and Pennsylvania, you will enjoy the flexibility to telecommute* as you take on some tough challenges. Applicants must be within commutable distance to Philadelphia, Kings, and Essex counties. **Travel:** Up to 50% **Primary Responsibilities:** + Assess complaints of alleged misconduct received within the Company + Investigate **low** to **medium** complex cases of fraud, waste and abuse + Detect fraudulent activity by members, providers, employees and other parties against the Company + Develop and deploy the most effective and efficient investigative strategy for each investigation + Maintain accurate, current and thorough case information in the Special Investigations Unit's (SIU's) case tracking system + Collect and secure documentation or evidence and prepare summaries of the findings + Participate in settlement negotiations and/or produce investigative materials in support of the latter + Collect, collate, analyze and interpret data relating to fraud, waste and abuse referrals + Ensure compliance of applicable federal/state regulations or contractual obligations + Report suspected fraud, waste and abuse to appropriate federal or state government regulators + Comply with goals, policies, procedures and strategic plans as delegated by SIU leadership + Collaborate with state/federal partners, at the discretion of SIU leadership, to include attendance at workgroups or regulatory meetings + Communicate effectively, including written and verbal forms of communication + Develop goals and objectives, track progress and adapt to changing priorities **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* 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 OR Associate's Degree + 2+ years of equivalent work experience with healthcare related employment + Basic level of proficiency in Microsoft Excel and Word + Ability to travel up to 50% within PA, NY, and NJ + Reside in PA, NY, or NJ - commutable distance to Philadelphia, Kings, and Essex counties + Ability to participate in legal proceedings, arbitration and depositions at the direction of management + Access to reliable transportation and valid US driver's license **Preferred Qualifications:** + License and/or Certified Pharmacy Technician (CPhT) + Accredited Health Care Fraud Investigator (AHFI) + Basic level of knowledge in health care policies, procedures and documentation standards + Basic level of skills in developing investigative strategies + Basic level of knowledge in pharmacy claims processing + Specialized knowledge/training in healthcare fraud, waste and abuse (FWA) investigations + Basic level of knowledge in analyzing data to identify FWA trends + Basic level of knowledge in state and federal regulatory FWA requirements + Active affiliations: + National Health Care Anti-Fraud Association (NHCAA) + Certified Fraud Examiner (CFE) + Operational experience with a pharmacy and/or pharmacy benefits manager (PBM) *All Telecommuters 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 salary for this role will range from $48,700 to $87,000 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._ _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._ \#RPO #GREEN
    $48.7k-87k yearly 60d+ ago
  • Pharmacy Investigator - Remote in NY, NJ, PA

    Unitedhealth Group 4.6company rating

    Philadelphia, PA jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** The **Investigator** is responsible for identification, investigation and prevention of healthcare fraud, waste and abuse. The **Investigator** will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. The **Investigator** is responsible to conduct investigations which may include field work to perform interviews and obtain records and/or other relevant documentation. If you reside within the state of New Jersey, New York, and Pennsylvania, you will enjoy the flexibility to telecommute* as you take on some tough challenges. Applicants must be within commutable distance to Philadelphia, Kings, and Essex counties. **Travel:** Up to 50% **Primary Responsibilities:** + Assess complaints of alleged misconduct received within the Company + Investigate **low** to **medium** complex cases of fraud, waste and abuse + Detect fraudulent activity by members, providers, employees and other parties against the Company + Develop and deploy the most effective and efficient investigative strategy for each investigation + Maintain accurate, current and thorough case information in the Special Investigations Unit's (SIU's) case tracking system + Collect and secure documentation or evidence and prepare summaries of the findings + Participate in settlement negotiations and/or produce investigative materials in support of the latter + Collect, collate, analyze and interpret data relating to fraud, waste and abuse referrals + Ensure compliance of applicable federal/state regulations or contractual obligations + Report suspected fraud, waste and abuse to appropriate federal or state government regulators + Comply with goals, policies, procedures and strategic plans as delegated by SIU leadership + Collaborate with state/federal partners, at the discretion of SIU leadership, to include attendance at workgroups or regulatory meetings + Communicate effectively, including written and verbal forms of communication + Develop goals and objectives, track progress and adapt to changing priorities **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* 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 OR Associate's Degree + 2+ years of equivalent work experience with healthcare related employment + Basic level of proficiency in Microsoft Excel and Word + Ability to travel up to 50% within PA, NY, and NJ + Reside in PA, NY, or NJ - commutable distance to Philadelphia, Kings, and Essex counties + Ability to participate in legal proceedings, arbitration and depositions at the direction of management + Access to reliable transportation and valid US driver's license **Preferred Qualifications:** + License and/or Certified Pharmacy Technician (CPhT) + Accredited Health Care Fraud Investigator (AHFI) + Basic level of knowledge in health care policies, procedures and documentation standards + Basic level of skills in developing investigative strategies + Basic level of knowledge in pharmacy claims processing + Specialized knowledge/training in healthcare fraud, waste and abuse (FWA) investigations + Basic level of knowledge in analyzing data to identify FWA trends + Basic level of knowledge in state and federal regulatory FWA requirements + Active affiliations: + National Health Care Anti-Fraud Association (NHCAA) + Certified Fraud Examiner (CFE) + Operational experience with a pharmacy and/or pharmacy benefits manager (PBM) *All Telecommuters 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 salary for this role will range from $48,700 to $87,000 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._ _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._ \#RPO #GREEN
    $48.7k-87k yearly 60d+ ago
  • Pharmacy Investigator - Remote in NY, NJ, PA

    Unitedhealth Group 4.6company rating

    Newark, NJ jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** The **Investigator** is responsible for identification, investigation and prevention of healthcare fraud, waste and abuse. The **Investigator** will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. The **Investigator** is responsible to conduct investigations which may include field work to perform interviews and obtain records and/or other relevant documentation. If you reside within the state of New Jersey, New York, and Pennsylvania, you will enjoy the flexibility to telecommute* as you take on some tough challenges. Applicants must be within commutable distance to Philadelphia, Kings, and Essex counties. **Travel:** Up to 50% **Primary Responsibilities:** + Assess complaints of alleged misconduct received within the Company + Investigate **low** to **medium** complex cases of fraud, waste and abuse + Detect fraudulent activity by members, providers, employees and other parties against the Company + Develop and deploy the most effective and efficient investigative strategy for each investigation + Maintain accurate, current and thorough case information in the Special Investigations Unit's (SIU's) case tracking system + Collect and secure documentation or evidence and prepare summaries of the findings + Participate in settlement negotiations and/or produce investigative materials in support of the latter + Collect, collate, analyze and interpret data relating to fraud, waste and abuse referrals + Ensure compliance of applicable federal/state regulations or contractual obligations + Report suspected fraud, waste and abuse to appropriate federal or state government regulators + Comply with goals, policies, procedures and strategic plans as delegated by SIU leadership + Collaborate with state/federal partners, at the discretion of SIU leadership, to include attendance at workgroups or regulatory meetings + Communicate effectively, including written and verbal forms of communication + Develop goals and objectives, track progress and adapt to changing priorities **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* 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 OR Associate's Degree + 2+ years of equivalent work experience with healthcare related employment + Basic level of proficiency in Microsoft Excel and Word + Ability to travel up to 50% within PA, NY, and NJ + Reside in PA, NY, or NJ - commutable distance to Philadelphia, Kings, and Essex counties + Ability to participate in legal proceedings, arbitration and depositions at the direction of management + Access to reliable transportation and valid US driver's license **Preferred Qualifications:** + License and/or Certified Pharmacy Technician (CPhT) + Accredited Health Care Fraud Investigator (AHFI) + Basic level of knowledge in health care policies, procedures and documentation standards + Basic level of skills in developing investigative strategies + Basic level of knowledge in pharmacy claims processing + Specialized knowledge/training in healthcare fraud, waste and abuse (FWA) investigations + Basic level of knowledge in analyzing data to identify FWA trends + Basic level of knowledge in state and federal regulatory FWA requirements + Active affiliations: + National Health Care Anti-Fraud Association (NHCAA) + Certified Fraud Examiner (CFE) + Operational experience with a pharmacy and/or pharmacy benefits manager (PBM) *All Telecommuters 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 salary for this role will range from $48,700 to $87,000 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._ _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._ \#RPO #GREEN
    $48.7k-87k yearly 60d+ ago
  • Clinical Pharmacist

    Unitedhealth Group Inc. 4.6company rating

    Wheelersburg, OH 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. We are currently conducting a search for a full-time Clinical Pharmacist to join a growing team of colleagues at our customer site, Southern Ohio Medical Center, to provide outstanding service to patients with complex, specialty diseases to help them achieve improved clinical outcomes. Pharmacy Location: Located within Southern Ohio Medical Center in Wheelersburg, OH Schedule: Monday through Friday 8:00am - 5:00pm Primary Responsibilities: * Establishing great working relationships with clinic staff and physicians in customer clinics * Leading medication management in the clinic(s), owning clinical outcome KPIs (as set), and ensuring that the patient/CPS engagement is appropriate and consistent with customer preferences. This includes: * Ensuring that every patient who can benefit from specialty pharmacy services is identified and met in clinic upon arrival * Showing patients, through action, the benefits of using the customer's specialty pharmacy services, without impeding the patient choice of pharmacy * Leading clinical follow-up with patients per defined protocols - through outbound phone calls and in-person appointments - to ensure patients are adherent to therapy and any issues are identified and resolved expediently * Accepting inbound calls from patients, and sharing in on-call coverage to ensure 24/7 patient support * Appropriately addressing clinical questions, triaging as appropriate * Partnering with physicians in clinics to ensure therapies selected are evidence-based * Participating in leadership and clinic staff meetings to help explain the CPS model * Assisting the site leader with recruiting and training of on-site Pharmacy Liaisons and Clinical Pharmacists * Assisting with dispensing, administrative, compliance-related or other tasks to ensure patients in the program receive unmatchable service 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: * PharmD or BS Pharmacy degree with equivalent and acceptable experience from a College of Pharmacy accredited by American Association of Colleges of Pharmacy (AACP) * Licensed to practice, or the ability to become licensed as a Pharmacist in the applicable state Preferred Qualification: * Pharmacy residency or Board Certification * 1+ years of clinical experience or residency equivalent is preferred, but all candidates will be considered * Ambulatory or specialty experience * Proficiency in multiple EMR systems such as Cerner, EPIC or Meditech * Proficiency with dispensing systems such as Willow Ambulatory, QS1, RX30, Computer Rx, etc. along with experience in pharmacy dispensing * Proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook) 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. 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.
    $51k-76k yearly est. 7d ago
  • Clinical Pharmacist

    Unitedhealth Group 4.6company rating

    Wheelersburg, OH 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.** We are currently conducting a search for a full-time Clinical Pharmacist to join a growing team of colleagues at our customer site, Southern Ohio Medical Center, to provide outstanding service to patients with complex, specialty diseases to help them achieve improved clinical outcomes. **Pharmacy Location:** Located within Southern Ohio Medical Center in Wheelersburg, OH **Schedule:** Monday through Friday 8:00am - 5:00pm **Primary Responsibilities:** + Establishing great working relationships with clinic staff and physicians in customer clinics + Leading medication management in the clinic(s), owning clinical outcome KPIs (as set), and ensuring that the patient/CPS engagement is appropriate and consistent with customer preferences. This includes: + Ensuring that every patient who can benefit from specialty pharmacy services is identified and met in clinic upon arrival + Showing patients, through action, the benefits of using the customer's specialty pharmacy services, without impeding the patient choice of pharmacy + Leading clinical follow-up with patients per defined protocols - through outbound phone calls and in-person appointments - to ensure patients are adherent to therapy and any issues are identified and resolved expediently + Accepting inbound calls from patients, and sharing in on-call coverage to ensure 24/7 patient support + Appropriately addressing clinical questions, triaging as appropriate + Partnering with physicians in clinics to ensure therapies selected are evidence-based + Participating in leadership and clinic staff meetings to help explain the CPS model + Assisting the site leader with recruiting and training of on-site Pharmacy Liaisons and Clinical Pharmacists + Assisting with dispensing, administrative, compliance-related or other tasks to ensure patients in the program receive unmatchable service 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:** + PharmD or BS Pharmacy degree with equivalent and acceptable experience from a College of Pharmacy accredited by American Association of Colleges of Pharmacy (AACP) + Licensed to practice, or the ability to become licensed as a Pharmacist in the applicable state **Preferred Qualification:** + Pharmacy residency or Board Certification + 1+ years of clinical experience or residency equivalent is preferred, but all candidates will be considered + Ambulatory or specialty experience + Proficiency in multiple EMR systems such as Cerner, EPIC or Meditech + Proficiency with dispensing systems such as Willow Ambulatory, QS1, RX30, Computer Rx, etc. along with experience in pharmacy dispensing + Proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook) 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._ _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._
    $51k-76k yearly est. 41d ago
  • Part-time Staff Pharmacist

    Unitedhealth Group Inc. 4.6company rating

    Logan, OH 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 within Hocking Valley Community Hospital - 601 OH-664 N, Logan, OH 43138 Hours: Monday-Friday 7:30am to 6:00pm and Saturdays 8:00am to 4:30pm closed on Sundays and some holidays 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) * 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 7d ago
  • Staff Pharmacist

    Unitedhealth Group Inc. 4.6company rating

    Logan, OH 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. The Staff Pharmacist will have the opportunity to apply your clinical expertise by evaluating and interpreting medication orders, compounding, and dispensing prescriptions in accordance with legal and professional standards. You will play a critical role in identifying, preventing, and resolving medication-related issues to ensure safe, effective, and individualized patient care. Through the application of evidence-based protocols, you will promote clinically sound and cost-effective drug therapy, contributing to improved patient outcomes and advancing the standard of pharmaceutical care. Pharmacy Location: Located within Hocking Valley Community Hospital - 601 OH-644 N, Logan, OH 43138 Hours: Monday-Friday 7:30a to 6:00p and Saturdays 8:00a to 4:30p closed Sundays and Holidays 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 * Active applicable state pharmacist license in good standing * 1+ years of recent pharmacist experience, (hospital setting preferred) * Skilled with pharmacy systems and Microsoft Office Preferred Qualifications: * PharmD * Residency training and hospital experience * Skilled with EPIC and Pyxis 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 7d ago
  • Staff Pharmacist

    Unitedhealth Group 4.6company rating

    Logan, OH 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.** The Staff Pharmacist will have the opportunity to apply your clinical expertise by evaluating and interpreting medication orders, compounding, and dispensing prescriptions in accordance with legal and professional standards. You will play a critical role in identifying, preventing, and resolving medication-related issues to ensure safe, effective, and individualized patient care. Through the application of evidence-based protocols, you will promote clinically sound and cost-effective drug therapy, contributing to improved patient outcomes and advancing the standard of pharmaceutical care. **Pharmacy Location** : Located within Hocking Valley Community Hospital - 601 OH-644 N, Logan, OH 43138 **Hours:** Monday-Friday 7:30a to 6:00p and Saturdays 8:00a to 4:30p closed Sundays and Holidays 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 + Active applicable state pharmacist license in good standing + 1+ years of recent pharmacist experience, (hospital setting preferred) + Skilled with pharmacy systems and Microsoft Office **Preferred Qualifications:** + PharmD + Residency training and hospital experience + Skilled with EPIC and Pyxis 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 49d ago
  • Part-time Staff Pharmacist

    Unitedhealth Group 4.6company rating

    Logan, OH 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 within Hocking Valley Community Hospital - 601 OH-664 N, Logan, OH 43138 **Hours:** Monday-Friday 7:30am to 6:00pm and Saturdays 8:00am to 4:30pm closed on Sundays and some holidays 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) + 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
  • Pharmacy Liaison

    Unitedhealth Group Inc. 4.6company rating

    Akron, OH 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 Specialty Pharmacy Liaison with CPS Solutions, LLC, you will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely with the CPS Patient Care Services team and works under the direct supervision of a pharmacist. Pharmacy Location: Located within Summa Health in Akron, OH Schedule: Monday through Friday 8:00am-5:00pm, 40 hours per week Primary Responsibilities: * Initializing and leading ongoing work in clinics and ensuring that the patient/CPS engagement is appropriate and consistent with their preferences. This includes: * Ensuring that every patient who can benefit from specialty pharmacy services is identified and met in clinic upon arrival * Explaining the benefits of our specialty pharmacy, without impeding patient choice of pharmacy, and achieving patient participation * Successfully enrolling patients into the program * Performing all benefits investigation, prior authorization, and financial assistance work needed to ensure patients have access to the medication they need * Overseeing services provided to enrolled patients - ensuring that everything from order entry to final verification is completed quickly, accurately, and in accordance with patients' needs * Providing direct support to enrolled patients to ensure that they are supported throughout their therapy regimen and achieve their intended outcome. This includes: * Conducting outbound phone calls for patient support, adherence checks, and refill reminders * Accepting inbound calls from patients, as needed and sharing in on call coverage to ensure 24/7 patient support * Appropriately triaging any clinical questions to an appropriate clinician (pharmacist, nurse, or provider) 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: * High school diploma or equivalent required; college degree preferred * Active Pharmacy Technician license in good standing in applicable state * Recent work experience as a Pharmacy Technician, ideally in specialty or outpatient settings * Experience supporting clinical pharmacy programs and performing administrative tasks such as prior authorizations and data entry Preferred Qualifications: * Experience in a health system specialty pharmacy as an in-clinic liaison * Experience working with various disease states * Solid knowledge of medication regimens, age-specific dosing, and managed care practices * Proficient in pharmacy systems, care management platforms, and Microsoft Office (Outlook, Word, Excel) 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 $17.74 to $31.63 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.
    $17.7-31.6 hourly 7d ago
  • Pharmacy Liaison

    Unitedhealth Group Inc. 4.6company rating

    Wheelersburg, OH 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 Specialty Pharmacy Liaison with CPS Solutions, LLC, you will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely with the CPS Patient Care Services team and works under the direct supervision of a pharmacist. Pharmacy Location: Southern Ohio Medical Center Specialty Pharmacy - 8940 Ohio River Rd Wheelersburg, OH 45694 Schedule: Monday through Friday 8:30am-5:00pm, 40 hours per week Primary Responsibilities: * Initializing and leading ongoing work in clinics and ensuring that the patient/CPS engagement is appropriate and consistent with their preferences. This includes: * Ensuring that every patient who can benefit from specialty pharmacy services is identified and met in clinic upon arrival * Explaining the benefits of our specialty pharmacy, without impeding patient choice of pharmacy, and achieving patient participation * Successfully enrolling patients into the program * Performing all benefits investigation, prior authorization, and financial assistance work needed to ensure patients have access to the medication they need * Overseeing services provided to enrolled patients - ensuring that everything from order entry to final verification is completed quickly, accurately, and in accordance with patients' needs * Providing direct support to enrolled patients to ensure that they are supported throughout their therapy regimen and achieve their intended outcome. This includes: * Conducting outbound phone calls for patient support, adherence checks, and refill reminders * Accepting inbound calls from patients, as needed and sharing in on call coverage to ensure 24/7 patient support * Appropriately triaging any clinical questions to an appropriate clinician (pharmacist, nurse, or provider) 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: * High school diploma or equivalent (college degree preferred) * Active Pharmacy Technician license in good standing in applicable state * Recent work experience as a Pharmacy Technician, ideally in specialty or outpatient settings * Experience supporting clinical pharmacy programs and performing administrative tasks such as prior authorizations and data entry Preferred Qualifications: * Experience in a health system specialty pharmacy as an in-clinic liaison * Experience working with various disease states * Solid knowledge of medication regimens, age-specific dosing, and managed care practices * Proficient in pharmacy systems, care management platforms, and Microsoft Office (Outlook, Word, Excel) 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 $17.74 to $31.63 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.
    $17.7-31.6 hourly 7d ago
  • Pharmacy Liaison

    Unitedhealth Group 4.6company rating

    Wheelersburg, OH 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 **Specialty Pharmacy Liaison** with CPS Solutions, LLC, you will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely with the CPS Patient Care Services team and works under the direct supervision of a pharmacist. **Pharmacy Location:** Southern Ohio Medical Center Specialty Pharmacy - 8940 Ohio River Rd Wheelersburg, OH 45694 **Schedule:** Monday through Friday 8:30am-5:00pm, 40 hours per week **Primary Responsibilities:** + Initializing and leading ongoing work in clinics and ensuring that the patient/CPS engagement is appropriate and consistent with their preferences. This includes: + Ensuring that every patient who can benefit from specialty pharmacy services is identified and met in clinic upon arrival + Explaining the benefits of our specialty pharmacy, without impeding patient choice of pharmacy, and achieving patient participation + Successfully enrolling patients into the program + Performing all benefits investigation, prior authorization, and financial assistance work needed to ensure patients have access to the medication they need + Overseeing services provided to enrolled patients - ensuring that everything from order entry to final verification is completed quickly, accurately, and in accordance with patients' needs + Providing direct support to enrolled patients to ensure that they are supported throughout their therapy regimen and achieve their intended outcome. This includes: + Conducting outbound phone calls for patient support, adherence checks, and refill reminders + Accepting inbound calls from patients, as needed and sharing in on call coverage to ensure 24/7 patient support + Appropriately triaging any clinical questions to an appropriate clinician (pharmacist, nurse, or provider) 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:** + High school diploma or equivalent (college degree preferred) + Active Pharmacy Technician license in good standing in applicable state + Recent work experience as a Pharmacy Technician, ideally in specialty or outpatient settings + Experience supporting clinical pharmacy programs and performing administrative tasks such as prior authorizations and data entry **Preferred Qualifications:** + Experience in a health system specialty pharmacy as an in-clinic liaison + Experience working with various disease states + Solid knowledge of medication regimens, age-specific dosing, and managed care practices + Proficient in pharmacy systems, care management platforms, and Microsoft Office (Outlook, Word, Excel) 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 $17.74 to $31.63 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._
    $17.7-31.6 hourly 60d+ ago
  • Specialty Pharmacy Liaison

    Unitedhealth Group Inc. 4.6company rating

    Gallipolis, OH 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 Specialty Pharmacy Liaison you will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely with the CPS Patient Care Services team and works under the direct supervision of a pharmacist. Pharmacy location: Located within Holzer Health System - 100 Jackson Pike, Gallipolis, OH 45631 Hours: Monday-Friday 8:30am to 5:30pm and no weekends 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: * High school diploma or equivalent * Active applicable state Pharmacy Technician license in good standing * Recent work experience as a Pharmacy Technician, ideally in specialty or outpatient settings * Solid knowledge of medication regimens, age-specific dosing, and managed care practices * Experience supporting clinical pharmacy programs and performing administrative tasks such as prior authorizations and data entry * Proficient in pharmacy systems, care management platforms, and Microsoft Office (Outlook, Word, Excel) * Comfortable interacting professionally with patients and providers via phone, in person, or telehealth Preferred Qualifications: * PTCB/CPhT 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 $17.74 to $31.63 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.
    $17.7-31.6 hourly 7d ago

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