Clinical Pharmacist jobs at PacificSource Health Plans

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. Position Purpose: Define and develop standard and custom formularies for assigned plan. Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated Monitor prior authorization requests Provide clinical support to internal departments and address clinical related questions Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice Develop and implement programs designed to impact DUR for both Medicaid and Medicare Develop, implement, and maintain policies and procedures for the pharmacy department Participate in the coordination of the Medicare MTM program Assist case management team with members including clinical rounds presentations Job Specific Duties: Quality-based outreach and data assessment, with an emphasis on support for Medicaid/Marketplace/Medicare members and measures. Impact on members/providers through a multitude of different job duties/functions. Support on other ad hoc initiatives at any time for SLT or as the needs of this business require. Disciplined execution with ability to communicate with providers/members/coworker Heavy on interdisciplinary work and cross functional collaboration. Excel/data assessment Working shift: 8am-5pm Monday - Friday (EST / Eastern) Education/Experience: Bachelor's degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience. Licenses/Certifications: Current state's Pharmacist license with no restrictions. * Please attach an up-to-date resume that meets Education / Experience requirements above to your application. * Pay Range: $105,600.00 - $195,400.00 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

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. Job Posting TitleClinical Integrity Pharmacist- REMOTE Summary Responsible for program alignment between the clinical team and other business units. Responsibilities include, but are not limited to, the maintenance of existing and development of new solutions to translate clinical content to other teams to meet business needs, triage IT requests, address analytic needs, maintain adequate documentation of processes, and provide clinical support. Job Description Serves as a program alignment liaison between the clinical team and other business units such as Clinical Operation, IT, Quality, Compliance, etc. Responsible for maintaining and validating clinical team content and perpetuating that content in collaboration with other teams. Triages clinical requests for existing and prospective opportunities for review and prioritization Contribution and coordination of clinical team support efforts for solutioning, enhancement, and development efforts for existing as well as new program/product offerings or implementations Provides clinical support to enhance analytic efforts. Provides clinical support for pipeline and other cross-functional team needs. Responsible for documentation of processes and procedures Responsible for quality and consistency monitoring and improvement efforts in collaboration with other business units RFP support Project maintenance and special projects Clinical research and support including policies and algorithms. Participates in and supports clinical meetings (e.g., TAC, P&T) Client support, including but not limited to, responding to inquiries, education, QPI support, clinical meetings, audit assistance, special projects, etc. Rebate compliance support Adheres to organizational policies and procedures. Ensures compliance with Federal and State laws and standards of practice which govern the profession of pharmacy. Maintains pharmacy records in accordance with all applicable state and federal laws and regulations. Maintains clinical skills and knowledge of pharmacotherapy by reviewing the literature, continuing education and any company provided in-services. Completes all mandatory company provided on-line courses. Attends and completes all employee development courses. Performs other duties as required. Required Qualifications Able to receive assignments in the form of high-level objectives and independently establish detailed goals to meet objectives. Strong interpersonal skills; excellent oral and written communication skills. Ability to function independently and as a team player. Good organizational and time management skills, with the ability to manage multiple tasks and be self-motivated. Proven ability to plan, organize, schedule, direct, control and monitor project activities. Well-developed interpersonal skills. Ability to interact at a high level with external contacts. Working knowledge of MS Office Suite Location Remote Certification/Licensure: Registered Pharmacist required PharmD preferred Preferred Qualifications: 5+ years of work experience Prior work experience in managed care or with a health plan Prior client-facing experience Prior experience with utilization management Strong MS Office skills, experience with databases and queries Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $108,000.00 - $184,000.00 based on experience and skills.To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. Positions will be posted for a minimum of five consecutive workdays.

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

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

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

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

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

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. Job Posting TitleClinical Staff Pharmacist RemoteJob Description The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests (i.e. formulary exceptions, prior authorization, step therapy, quantity limit exceptions) for delegated products and services. Responsibilities Responsible for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, step therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client's pre-approved criteria Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues Collaborate with team members to promote consistency of decisions across the pharmacist team Other duties as assigned Minimum Qualifications Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree Current pharmacist license in good standing with the State Board of Pharmacy 1 year relevant work experience Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications Excellent verbal and written communication skills Ability to work independently and as part of a team Preferred Qualifications Managed care experience Proficiency with Microsoft Office Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $51.92 - $88.46 based on experience and skills.To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. Positions will be posted for a minimum of five consecutive workdays.

Under the direction of the Manager, Case Management works with members/providers to address and optimize members medication profiles. The associate will focus on assessing, and monitoring member's drug therapies. The associate identifies issues, makes recommendations works with the health care team and implements interventions. The Clinical Pharmacist facilitates communication and serves as a liaison and educator between the member, family, the Plan, and all members of the health care team, thus promoting high quality, cost-effective services. Duties and Responsibilities: Responsible for evaluating members entire medication profile and optimizing member's drug therapy * Appropriately contacts and assesses the member to identify and resolve medication gaps * missing medication and affordability issues * prior auth issues and appeals * Address Polypharmacy and works to reducing the number of medications to increase adherence. * The associate optimizes the member's benefit by promoting effective and efficient use of health care / Pharmacy resources. * Address inappropriate/missing medications * Educate on benefits, formulary * Routinely provides members with proper information for the safe and effective use of medications * Drug therapy optimization, ensuring proper drug dosage and cross-drug utilization * Improve medication adherence * address patient/family concerns/questions, and provide education on pharmacotherapy * Adverse side effect mitigation * Drive towards most cost-effective medications * Reduce pharmacy and medical spend * Coordinate recommendations with nurse health coach and member's providers * Monitors the effectiveness of the Medication plan and documents interventions and follow-up * Accurately documents within the manage care system, utilizing appropriate standard templates and identifies themselves as the Clinical pharmacist working with the member. * The associate develops a strong understanding of community resources with may be recommended to support the member/family beyond the Plan's benefit parameters * The associate provides exceptional customer service to all internal and external customers. * Maintains current knowledge necessary to provide pharmacy services of the highest standards * Other duties as assigned Qualifications - External Required Qualifications: * Doctor of Pharmacy or Bachelor of Science Degree in Pharmacy plus 1-3 years of relevant clinical experience * Active State Pharmacy License * At least 5 years practice experience or accredited Managed Care Residency Preferred experience: * Current knowledge and expertise in clinical pharmacology, disease management and managed care * Experience with team-based care * Self-management Skills - self-motivated, organized, detail oriented and manages time and resources effectively. Must be able to work independently in a collaborative environment, be self-directed and possess excellent organizational and time management skills * Computer/Technology Competency: Proficient in use of Microsoft Word, Excel, and Outlook Fully Remote: This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence's physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania. IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

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

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

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

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

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

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

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. The Clinical Pharmacist, Medical Pharmacy is a member of the clinical pharmacy team. The incumbent has responsibility and accountability for overseeing the medical pharmacy clinical strategy for all business segments including IFB, Commercial, Medicaid and Medicare. Key accountabilities include, but are not limited to, leading medical pharmacy policy development and utilization management for all segments, new medical drug clinical assessment and management strategy; and oversight for both internal and delegated medical pharmacy management services. This will include navigating cross-functional processes and systems both within and external to the organization. The position will present medical pharmacy trend and opportunities to key strategic clients. This position works closely with the Manager, Clinical Pharmacy to ensure cohesion between strategic, clinical, and operational strategies within Pharmacy Services to deliver efficient, effective, and high-quality medical pharmacy services to our customers. Performs other duties as assigned. Key Accountabilities Provides oversight and support for all aspects of the medical pharmacy benefit, including elements such as drug policies, clinical services, and utilization management. Develops and implements strategies to manage medical drug costs and improve member outcomes consistent across all segments and markets Prepares and presents medical drug reviews at Medica's formal approval committee Reviews and analyzes medical drug utilization data to ensure optimal usage of medications Ensures access to cost-effective medical drugs for our customers Develops and implements medical pharmacy policies and procedures Ensures compliance with regulatory standards across all segments and markets Ensures the efficient and effective delivery of medical pharmacy services for customers Represents medical pharmacy services and actively participates in both internal and external cross-functional meetings Maintains up-to-date knowledge of new drugs, therapeutic trends, and healthcare laws and regulations Maintains accurate and current records of all medical pharmacy decisions and changes Addresses inquiries and disputes related to medical pharmacy authorization decisions Completes projects as assigned Actively participates in internal and external pharmacy meetings Required Qualifications Bachelor's Degree, B.S. Pharmacy or PharmD Required 7 years of work experience beyond degree Required Certifications/Licensure Active Pharmacist License Preferred Qualifications 1+ year related work experience specifically focused on medical pharmacy management Prior experience with medical pharmacy policy development and utilization management preferred Organized and can simultaneously execute through multiple projects and priorities Proven track record on consistently achieving desired results Self-starter, possessing willingness and ambition to work through ambiguity Creative thinker Excellent analytical and decision-making skills Motivated to problem solve Ability to present to an executive audience Collaborative, team-oriented spirit Excellent written and verbal communication skills Customer/patient focused This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, Madison, WI, Omaha, NE or St. Louis, MO. The full salary grade for this position is $111,200 - $190,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $111,200 - $166,740. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Founded in 1985, SelectQuote (NYSE: SLQT) provides solutions that help consumers protect their most valuable assets: their families, health and property. SelectRX, a subsidiary of SelectQuote, is prioritizing important population health initiatives focused on actively managed, high-touch patient experience by improving patient engagement and health literacy, simplifying the healthcare journey and facilitating better healthcare options through value-based partnerships. SelectRX is a high touch, technology-driven specialized medication management pharmacy. We engage virtually with patients to ensure accurate prescription records are maintained in order to achieve improved prescription drug adherence. SelectRX does this by providing a personalized clinical approach driven by a robust technology platform to track adherence with a world-class pharmaceutical packing and distribution facility. About the Role This role is located onsite and requires availability for our 6:00am - 2:30pm CST shift. Under the direct supervision of the Pharmacy Manager the Staff Pharmacist is responsible and accountable for the provision of safe effective and prompt medication therapy. The staff Pharmacist participates in all necessary aspects of the medication-use system while providing comprehensive and individualized pharmaceutical care to the patients in their assigned areas. Supervisory Responsibilities: * This position has no direct supervisory responsibilities. Essential Duties and Responsibilities: * Operate within the professional standards and in compliance with Federal State and local regulations * Performs professional duties and responsibilities associated with the processing of prescriptions to meet the * SelectRx objectives and personally maintains a high level of customer satisfaction * Compounds dispenses checks and verifies that all prescription and health-related product orders are processed in accordance with Federal State and local laws and regulations governing the dispensing of medications and other healthcare-related products * Implement and maintain policies and procedures of the Pharmacy Department. * Comply and adhere to professional practices and management of hourly pharmacy associates * Assist in training and supervising pharmacy technicians and other support staff * Assist in monitoring pharmacy associates performance ratings * Assist the Pharmacy Manager in ensuring profitable operations of the Pharmacy Department * Actively develops and oversees policies and procedures for drug purchasing drug distribution and inventory drug control * Reviews pharmacy audit reports and implements cost-saving initiatives * Implement audit and quality control procedures to ensure compliance with SelectRx and regulatory requirements * Maintains files records and submits required pharmacy reports * Identifies evaluates and interprets prescriptions * Receives new prescription orders orally from prescribers or other persons authorized by law * Ability to monitor drug therapy of patients and recognizes significant drug interactions * Supervises the packaging of drugs and checks the packaging procedure and product upon completion * Responsible for overseeing all activities of pharmacy technicians to ensure that all activities are performed completely safely and without risk or harm to patients * Consults with patients or his/her agent regarding prescriptions either prior to or after dispensing or regarding any medical information contained in patients' medication record system or patient chart as mandated by OBRA regulations * Consult with any prescriber nurse or other health care professional or authorized agent thereof * Develop and maintain professional relationships with the medical community in which SelectRx serves * Resolves customer complaints and recommends corrective action plans * Treats all patients/clients with respect and courtesy; respects the patients'/clients' rights to confidentiality and works cooperatively with other members of professional and non-professional staff * Attend SelectRx team meetings when requested Skills/Abilities: * Must possess the ability to work with automated prescription systems Maintains proficiency in pharmacy computer systems and medication ordering systems Possess good organizational and time-management skills Demonstrates appropriate written and oral communication skills A high degree of interpersonal and organizational skills Understand and maintain confidentiality regarding patient medications and illnesses (HIPAA) Ability to effectively interact with all levels of management associates clients and the general public Proficiency in reading writing and speaking is required Education and Experience: * Bachelor of Science degree or Pharm.D. Degree from an accredited School of Pharmacy Certificates/Licenses/Registration * Must currently be licensing by the Kansas Board of Pharmacy to practice pharmacy in the state of Kansas Physical Requirements: * Prolonged periods of standing at a desk and working on a computer SelectQuote Core Values: Service: We create positive customer experiences. Entrepreneurship: We create innovate & take risks. Leadership: We build & invest in high-performing teams. Empowerment: We embrace a changing environment. Courage: We challenge the status quo & drive continuous improvement. Teamwork: We help support & celebrate each other. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required. Our Benefits We are proud to offer the following benefits: * Competitive Medical, Dental, and Vision insurance * HSA/FSA * Voluntary Hospital Indemnity, Critical Illness, accident insurance, and short term disability * Voluntary Life Insurance for self, spouse and dependent * Company-paid Basic Life Insurance and Long Term Disability * Retirement plan and employer match contribution with Profit Share * Tuition Reimbursement program * Company perks and discount program * Engaging Wellness and financial education resources * Employee Assistance Program * Incentive Plans Responsibilities Founded in 1985, SelectQuote (NYSE: SLQT) provides solutions that help consumers protect their most valuable assets: their families, health and property. SelectRX, a subsidiary of SelectQuote, is prioritizing important population health initiatives focused on actively managed, high-touch patient experience by improving patient engagement and health literacy, simplifying the healthcare journey and facilitating better healthcare options through value-based partnerships. SelectRX is a high touch, technology-driven specialized medication management pharmacy. We engage virtually with patients to ensure accurate prescription records are maintained in order to achieve improved prescription drug adherence. SelectRX does this by providing a personalized clinical approach driven by a robust technology platform to track adherence with a world-class pharmaceutical packing and distribution facility. Qualifications This role is located onsite and requires availability for our 6:00am - 2:30pm CST shift. Under the direct supervision of the Pharmacy Manager the Staff Pharmacist is responsible and accountable for the provision of safe effective and prompt medication therapy. The staff Pharmacist participates in all necessary aspects of the medication-use system while providing comprehensive and individualized pharmaceutical care to the patients in their assigned areas. Supervisory Responsibilities: * This position has no direct supervisory responsibilities. Essential Duties and Responsibilities: * Operate within the professional standards and in compliance with Federal State and local regulations * Performs professional duties and responsibilities associated with the processing of prescriptions to meet the * SelectRx objectives and personally maintains a high level of customer satisfaction * Compounds dispenses checks and verifies that all prescription and health-related product orders are processed in accordance with Federal State and local laws and regulations governing the dispensing of medications and other healthcare-related products * Implement and maintain policies and procedures of the Pharmacy Department. * Comply and adhere to professional practices and management of hourly pharmacy associates * Assist in training and supervising pharmacy technicians and other support staff * Assist in monitoring pharmacy associates performance ratings * Assist the Pharmacy Manager in ensuring profitable operations of the Pharmacy Department * Actively develops and oversees policies and procedures for drug purchasing drug distribution and inventory drug control * Reviews pharmacy audit reports and implements cost-saving initiatives * Implement audit and quality control procedures to ensure compliance with SelectRx and regulatory requirements * Maintains files records and submits required pharmacy reports * Identifies evaluates and interprets prescriptions * Receives new prescription orders orally from prescribers or other persons authorized by law * Ability to monitor drug therapy of patients and recognizes significant drug interactions * Supervises the packaging of drugs and checks the packaging procedure and product upon completion * Responsible for overseeing all activities of pharmacy technicians to ensure that all activities are performed completely safely and without risk or harm to patients * Consults with patients or his/her agent regarding prescriptions either prior to or after dispensing or regarding any medical information contained in patients' medication record system or patient chart as mandated by OBRA regulations * Consult with any prescriber nurse or other health care professional or authorized agent thereof * Develop and maintain professional relationships with the medical community in which SelectRx serves * Resolves customer complaints and recommends corrective action plans * Treats all patients/clients with respect and courtesy; respects the patients'/clients' rights to confidentiality and works cooperatively with other members of professional and non-professional staff * Attend SelectRx team meetings when requested Skills/Abilities: * Must possess the ability to work with automated prescription systems Maintains proficiency in pharmacy computer systems and medication ordering systems Possess good organizational and time-management skills Demonstrates appropriate written and oral communication skills A high degree of interpersonal and organizational skills Understand and maintain confidentiality regarding patient medications and illnesses (HIPAA) Ability to effectively interact with all levels of management associates clients and the general public Proficiency in reading writing and speaking is required Education and Experience: * Bachelor of Science degree or Pharm.D. Degree from an accredited School of Pharmacy Certificates/Licenses/Registration * Must currently be licensing by the Kansas Board of Pharmacy to practice pharmacy in the state of Kansas Physical Requirements: * Prolonged periods of standing at a desk and working on a computer SelectQuote Core Values: Service: We create positive customer experiences. Entrepreneurship: We create innovate & take risks. Leadership: We build & invest in high-performing teams. Empowerment: We embrace a changing environment. Courage: We challenge the status quo & drive continuous improvement. Teamwork: We help support & celebrate each other. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required.

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit **************** Position Summary: The Formulary Operations Pharmacist - Medicare is responsible for providing operational support for the evaluation, implementation, and maintenance of Medicare Part D formularies and utilization management. This individual supports creation and maintenance of formulary and utilization management lists, preparation of CMS formulary files and member formulary drug lists, preparation and review of updates for implementation, and other formulary and utilization management related tasks and processes. The role requires strong cross functional collaboration and communication skills, and an understanding of Medicare Part D formulary management processes and related CMS rules and regulations. Position Responsibilities: Maintain standard and custom formularies for the Medicare line of business in accordance with CMS Medicare guidelines Support development, implementation, maintenance, and quality control of Medicare Part D formularies, utilization management, and clinical adjudication drug lists Lead and support preparation of monthly and annual files for CMS formulary submissions, member formulary drug lists and look up tools, and utilization management criteria Evaluate drugs/drug classes, make formulary positioning and utilization management recommendations, and update formulary management strategies and associated adjudication requirements to operationalize Evaluate appropriateness of and operationalize custom client formulary and benefit change requests within the formulary and adjudication platform Support comprehensive testing of client formulary and benefit elections Provide cross functional support for claim troubleshooting within the adjudication platform Monitor and analyze regulatory and legislative requirements for Medicare Support development of project plans to meet new CMS requirements, and support cross functional teams with implementation of programs to meet requirements Lead formulary change processes within URAC/NCQA/CMS guidelines Pharmacy and Therapeutics (P&T) Committee participation as an ad hoc member Conduct formulary reviews and develop drug monographs based on a rotation of clinical pharmacists Maintain and update the Capital Rx pharmaceutical pipeline, as needed Develop clinical criteria for review as needed Support CMS formulary administration audits Support quality improvement projects as needed Support Request for Information (RFI) and Request for Proposal (RFP) submissions, as needed Support general business needs and operations, as needed Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Minimum Qualifications: Doctor of Pharmacy (PharmD) Degree from an accredited institution, with record of strong academic performance Current, unrestricted registered pharmacist license(s) Residency/fellowship preferred 2-3 years of formulary experience working for a health plan or PBM preferred 2-3 years of Medicare experience preferred Knowledge of formulary development and maintenance processes Knowledge of highly managed specialty medications/strategy Knowledge of rebate and financial implications of formulary strategies Experience working with large datasets preferred Ability to independently identify, research, and resolve issues Ability to balance multiple complex projects simultaneously Ability to work extended hours, weekends, and holidays consistent with industry demands Exceptional written and verbal communication skills Extremely flexible, highly organized, and able to shift priorities easily Attention to detail & commitment to delivering high quality work product Microsoft office suite with emphasis on Microsoft excel proficiency required #LI-BC1 Salary Range$125,000-$135,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************

Schedule: Full-Time, Monday - Friday, 9:00 AM - 6:00 PM Compensation Range: $19.00 - $21.00/ Hour is not Remote nor Hybrid) Join Our Team and Make a Difference in Patient's Lives! As a Pharmacy Patient Advocate, you will be a crucial link between patients, medical providers, and our pharmacy. You will make a direct impact by eliminating barriers to medication access, ensuring patients receive their specialty medications in a timely and affordable manner. If you are a problem-solver with a background in pharmacy services and a desire to provide an exceptional patient experience, we encourage you to apply! What You'll Do (Key Responsibilities include but are not limited to): * Serve as a Patient Liaison: Act as the central point of contact between patients, physician offices, manufacturer programs, and insurance payers to resolve medication access issues. * Navigate Benefits & Authorizations: Conduct comprehensive benefit investigations, manage prior authorizations, and coordinate benefits to minimize patient out-of-pocket costs. * Manage Patient Communications: Handle inbound calls for prescription inquiries and outbound calls for patient welcome, refill scheduling, and provider follow-ups. * Ensure Seamless Coordination: Coordinate timely and accurate medication deliveries with patients and providers, ensuring adherence to treatment plans. * Maintain Accurate Records: Collect and maintain confidential patient information, including allergies, contact details, and payment methods, while upholding all HIPAA regulations. * Support Clinical Integrity: Direct all clinical inquiries and patient concerns to a licensed pharmacist to ensure patient safety and proper care. * Utilize Technology: Leverage pharmacy operating systems and other software tools to manage patient cases, track communications, and ensure efficient service delivery. What You'll Bring (Qualifications & Skills) * High school diploma or GED. * Active Florida Pharmacy Technician Registration required. * A minimum of two (2) years of experience in a customer service setting OR one (1) year of experience in specialty pharmacy. * Prior authorization experience required. * Strong knowledge of medical and pharmacy terminology. * Benefit investigation experience preferred. * Excellent communication skills. * Basic computation skills. * Bilingual - English and Spanish preferred. * Microsoft Office or Google Suite proficiency. * RMA or CMA certified preferred, but not required. Work Environment & Physical Demands * This role is primarily sedentary and requires the ability to sit for extended periods (minimum of 7 hours). The position required strong multitasking skills, attentions to detail, and the ability to lift and/o move up to 20 lbs. The Perks of Joining Our Team: We believe in taking care of our team. You'll enjoy a comprehensive benefits package designed to support your well-being and financial future: * Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance. * Time to Recharge: Paid vacation and holiday pay. * Focus on Your Wellness: We offer a robust Employee Wellness Program. * Invest in Your Future: 401(k) with a company match. * Support System: Employee Assistance Program provides confidential support and counseling. * Get Rewarded for Referring Great People: Employee referral program. Ready to start your rewarding journey with us? Apply today! Please note while this job description is a comprehensive overview, additional responsibilities may be part of the role. ProCare Rx will never ask for a financial commitment from an applicant as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our official recruitment team at ****************. ProCare Rx is an Equal Opportunity Employer.