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Pharmacist jobs at Presbyterian

- 20 jobs
  • Pharmacist - Neonatal/Pediatrics - Pharmacy

    Presbyterian Healthcare Services 4.8company rating

    Pharmacist job at Presbyterian

    Presbyterian is seeking a dedicated and detail-oriented Pediatric & Neonatal Pharmacist to join our multidisciplinary team. This role plays a critical part in ensuring safe, effective, and evidence-based medication therapy for neonates, infants, and children for inpatient units. The Pharmacist must have excellent communication skills since they often work closely with doctors and other healthcare professionals to ensure that patients receive the right medication and dosage for their medical conditions. Type of Opportunity: Full Time (1.0 FTE/40 hours per week) Work Schedule: Varied Days and Hours Sign on bonus available for qualified candidates. How you grow, learn and thrive matters here. * Educational and career development options, including tuition and certification reimbursement, scholarship opportunities * Wearable duress alarm technology (a wearable badge that allows staff to quickly and discreetly call for help when safety is a concern) * Shift differentials for nights and weekends * Differentials for higher education, certifications and various lead roles * Malpractice liability insurance * Loan forgiveness through the New Mexico Higher Education Department * EPIC electronic charting system Qualifications * Bachelor's degree * Education specialization: Pharmacy * Registered Pharmacist * Licensed New Grads are welcome to apply. * Responsible for on-call, weekend, night, and/or holiday coverage as required on a rotating basis. * Less than one year experience in pharmacy practice preferred. Responsibilities * Maintains established departmental policies and procedures, objectives, PI program, safety, environmental, and infection control standards. * Compounds, packages, labels, and dispenses medications. * Advises patients and families on the use of medications including dosage, side effects, and composition. * Maintains professional growth and development through participation in educational programs, current literature, in-services, and workshops. * Monitors medication use for appropriateness. * Oversees the activities of technicians, interns, and students. * Participates in education programs for pharmacy staff, attends meetings as required, and participates on committees as needed. * Participates in training pharmacists, technicians, students, and residents. * Consults with and advises healthcare providers regarding optimal and cost-effective utilization of drugs. * Performs other functions as required. Benefits We're all about well-being, starting with yours.Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more. Learn more about our employee benefits. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses. Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $77.92/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
    $77.9 hourly Auto-Apply 60d ago
  • Manager, Pharmacy Healthcare Analytics - Tableau/Power BI/SQL - Remote

    Molina Healthcare 4.4company rating

    Santa Fe, NM jobs

    Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Pharmacy Department. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths. + Daily management of Pharmacy Healthcare Analytics team. + Allocate new report/project requests (workload distribution). + Coordinates with Pharmacy Department to meet data analysis and database development needs. + Reviews, evaluates, and improved Company business logic and data sources. + Resource to Pharmacy Department staff for mentoring, coaching, and analysis questions. + Reviews Pharmacy analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan project documentation. + Maintains reporting service level benchmarks for Healthcare Analytics team. + Represents Pharmacy Analytics and Reporting department in cross-departmental and operational meetings. + Serves as liaison between Corporate IT and Pharmacy Department regarding reporting needs. + Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management. + Interfaces and maintains positive interactions with Pharmacy Department, Health Plan and Corporate personnel. + Management Pharmacy Department workflow process. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field **Required Experience** + 3 years management or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5 years supervisory experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $50k-106k yearly est. 22d ago
  • Manager, Pharmacy Healthcare Analytics - Tableau/Power BI/SQL - Remote

    Molina Healthcare 4.4company rating

    Albuquerque, NM jobs

    Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Pharmacy Department. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths. + Daily management of Pharmacy Healthcare Analytics team. + Allocate new report/project requests (workload distribution). + Coordinates with Pharmacy Department to meet data analysis and database development needs. + Reviews, evaluates, and improved Company business logic and data sources. + Resource to Pharmacy Department staff for mentoring, coaching, and analysis questions. + Reviews Pharmacy analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan project documentation. + Maintains reporting service level benchmarks for Healthcare Analytics team. + Represents Pharmacy Analytics and Reporting department in cross-departmental and operational meetings. + Serves as liaison between Corporate IT and Pharmacy Department regarding reporting needs. + Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management. + Interfaces and maintains positive interactions with Pharmacy Department, Health Plan and Corporate personnel. + Management Pharmacy Department workflow process. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field **Required Experience** + 3 years management or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5 years supervisory experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $50k-106k yearly est. 22d ago
  • Manager, Pharmacy Healthcare Analytics - Tableau/Power BI/SQL - Remote

    Molina Healthcare 4.4company rating

    Houston, TX jobs

    Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Pharmacy Department. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths. + Daily management of Pharmacy Healthcare Analytics team. + Allocate new report/project requests (workload distribution). + Coordinates with Pharmacy Department to meet data analysis and database development needs. + Reviews, evaluates, and improved Company business logic and data sources. + Resource to Pharmacy Department staff for mentoring, coaching, and analysis questions. + Reviews Pharmacy analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan project documentation. + Maintains reporting service level benchmarks for Healthcare Analytics team. + Represents Pharmacy Analytics and Reporting department in cross-departmental and operational meetings. + Serves as liaison between Corporate IT and Pharmacy Department regarding reporting needs. + Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management. + Interfaces and maintains positive interactions with Pharmacy Department, Health Plan and Corporate personnel. + Management Pharmacy Department workflow process. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field **Required Experience** + 3 years management or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5 years supervisory experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $47k-97k yearly est. 22d ago
  • Clinical Informatics Pharmacist

    Geisinger Medical Center 4.7company rating

    Remote

    Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Collaborates with both inpatient and outpatient pharmacy IT and Clinical Informatics for the selection, implementation, and evaluation of automated technology and computerization of pharmacy-related patient care activities including decision support. Works with other external departments to coordinate drug delivery and pharmaceutical care. Job Duties: Works in the build, implementation, integration, and maintenance of automation and technology to assure safe and appropriate use of medications. Assures appropriate testing of all integrated applications. Evaluates and tests system upgrades, new functionality, program implementation changes relative to the changes in pharmacy practice. Facilitates problems with pharmacy technology and issues related to decision support and database management. Provides pharmacy technology related in-service education for pharmacists, pharmacy technicians, and external department staff. Provides support for workflow analysis and training during implementation of new EMR go lives. Is a resource for Revenue Cycle and Revenue Management to troubleshoot charge errors in Siemens or Epic. Responsible for updating the Charge Description Master for medications. Including descriptions, coding and charges. Provides support for the 340b Director for charge and dispense information going to the 340b accumulator from electronic systems. Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position. Position Details: Must-Have Skills: Strong understanding of related applications, including Epic Critical thinking Problem Management Preferred Skills: Communication Teamwork IT Project planning Software, Tools, and Applications: Epic Other pharmacy IT systems (Medication dispensing cabinets, labeling systems, prepackaging systems, other robotics) Education: Bachelor's Degree-Pharmacy (Required), Master's Degree-Computer Science, Information Systems, Information Science (Preferred) Experience: Minimum of 4 years-Related work experience (Required) Certification(s) and License(s): Licensed Pharmacist - Default Issuing Body Skills: Teamwork OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
    $89k-138k yearly est. Auto-Apply 37d ago
  • Manager, Pharmacy Healthcare Analytics - Tableau/Power BI/SQL - Remote

    Molina Healthcare 4.4company rating

    Rio Rancho, NM jobs

    Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Pharmacy Department. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths. + Daily management of Pharmacy Healthcare Analytics team. + Allocate new report/project requests (workload distribution). + Coordinates with Pharmacy Department to meet data analysis and database development needs. + Reviews, evaluates, and improved Company business logic and data sources. + Resource to Pharmacy Department staff for mentoring, coaching, and analysis questions. + Reviews Pharmacy analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan project documentation. + Maintains reporting service level benchmarks for Healthcare Analytics team. + Represents Pharmacy Analytics and Reporting department in cross-departmental and operational meetings. + Serves as liaison between Corporate IT and Pharmacy Department regarding reporting needs. + Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management. + Interfaces and maintains positive interactions with Pharmacy Department, Health Plan and Corporate personnel. + Management Pharmacy Department workflow process. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field **Required Experience** + 3 years management or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5 years supervisory experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $50k-106k yearly est. 22d ago
  • Manager, Pharmacy Healthcare Analytics - Tableau/Power BI/SQL - Remote

    Molina Healthcare 4.4company rating

    Las Cruces, NM jobs

    Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to provider networks and other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Pharmacy Department. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths. + Daily management of Pharmacy Healthcare Analytics team. + Allocate new report/project requests (workload distribution). + Coordinates with Pharmacy Department to meet data analysis and database development needs. + Reviews, evaluates, and improved Company business logic and data sources. + Resource to Pharmacy Department staff for mentoring, coaching, and analysis questions. + Reviews Pharmacy analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan project documentation. + Maintains reporting service level benchmarks for Healthcare Analytics team. + Represents Pharmacy Analytics and Reporting department in cross-departmental and operational meetings. + Serves as liaison between Corporate IT and Pharmacy Department regarding reporting needs. + Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management. + Interfaces and maintains positive interactions with Pharmacy Department, Health Plan and Corporate personnel. + Management Pharmacy Department workflow process. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field **Required Experience** + 3 years management or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5 years supervisory experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $52k-109k yearly est. 22d ago
  • Pharmacy Representative

    Molina Healthcare 4.4company rating

    Santa Fe, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-28.8 hourly 42d ago
  • Pharmacy Representative

    Molina Healthcare Inc. 4.4company rating

    Santa Fe, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties * Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. * Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with initiating verbal and written coverage determinations and appeals. * Records calls accurately within the pharmacy call tracking system. * Maintains established pharmacy call quality and quantity standards. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. * Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications * At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications * Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. * Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-28.8 hourly 21d ago
  • Pharmacy Representative

    Molina Healthcare 4.4company rating

    Albuquerque, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-28.8 hourly 42d ago
  • Pharmacy Representative

    Molina Healthcare Inc. 4.4company rating

    Albuquerque, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties * Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. * Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with initiating verbal and written coverage determinations and appeals. * Records calls accurately within the pharmacy call tracking system. * Maintains established pharmacy call quality and quantity standards. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. * Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications * At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications * Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. * Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-28.8 hourly 21d ago
  • Specialty Pharmacy Clinical Pharmacy Specialist

    Franciscan Health Indianapolis 4.1company rating

    Michigan City, IN jobs

    Franciscan Health Michigan City Campus3500 Franciscan Way Michigan City, Indiana 46360 The Clinical Pharmacy Specialist provides comprehensive pharmacotherapy services for patient populations, responds to complex drug therapy issues, and provides leadership to improve medication use. The Specialist leads education efforts for Clinical Staff Pharmacists, Pharmacy Students, Pharmacy Residents, and other healthcare professionals. This position collaborates with other Franciscan Alliance medical staff and facilities to achieve best practices and optimal outcomes for all patients. REMOTE POSITION. POSSIBLE ONSITE WORK AT FRANCISCAN HEALTH MICHIGAN CITY. MUST HAVE ACTIVE INDIANA PHARMACIST LICENSE. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Collaborate with allied health disciplines to provide quality patient care. Consult with and advise other Healthcare professionals and patients on matters pertaining to selection, procurement, distribution, and safe and appropriate use of medications. Coordinate and deliver ongoing staff education for clinical staff pharmacist. Direct and precept students and/or residents. Lead cost effective formulary management initiatives. Review adverse events related to the medication use process, recommend improvements to the medication use process, as needed, and ensure improvements are implemented. Review literature and publications in area of specialization, and recommend improvements to the medication use process. Review prescriptions and medication orders, check for appropriateness, and provide information needed to properly and safely administer the medication. Attend and participate in local and system-wide committees to improve the medication use process. Draft, review, and revise medication related policies, procedures, guidelines and protocols. Provide clinical pharmacy services as outlined in approved hospital policies, including but not limited to: pharmacokinetic consults, renal dosing, parenteral nutrition management, anticoagulation management, neonatal/pediatric/geriatric dosing management, route optimization, antimicrobial stewardship, and reviewing medications at transitions of care. QUALIFICATIONS Required Bachelor's Degree Pharmacy Preferred Doctorate Pharmacy 1 year PGY1 Pharmacy Residency Required 3 years In area of specialization Required 1 year PGY-2 Pharmacy residency Preferred Registered Pharmacist (RPh) - State Licensing Board Board Certified in applicable area of specialty or pharmacotherapy (if specialty area not available) - . Required within 24 months Basic Life Support Program (BLS) - American Heart Association As required by unit TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Clinical Pharmacy Specialist $128960.00-$153140.00INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
    $71k-122k yearly est. Auto-Apply 60d+ ago
  • Pharmacy Representative

    Molina Healthcare 4.4company rating

    New Mexico jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-28.8 hourly 42d ago
  • Pharmacy Representative

    Molina Healthcare 4.4company rating

    Roswell, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-28.8 hourly 42d ago
  • Pharmacy Representative

    Molina Healthcare Inc. 4.4company rating

    Roswell, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties * Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. * Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with initiating verbal and written coverage determinations and appeals. * Records calls accurately within the pharmacy call tracking system. * Maintains established pharmacy call quality and quantity standards. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. * Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications * At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications * Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. * Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-28.8 hourly 21d ago
  • Pharmacy Representative

    Molina Healthcare Inc. 4.4company rating

    Rio Rancho, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties * Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. * Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with initiating verbal and written coverage determinations and appeals. * Records calls accurately within the pharmacy call tracking system. * Maintains established pharmacy call quality and quantity standards. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. * Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications * At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications * Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. * Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-28.8 hourly 21d ago
  • Pharmacy Representative

    Molina Healthcare 4.4company rating

    Rio Rancho, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-28.8 hourly 42d ago
  • Pharmacy Representative

    Molina Healthcare 4.4company rating

    Las Cruces, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties - Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. - Provides coordination and processing of pharmacy prior authorization requests and/or appeals. - Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. - Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. - Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. - Assists members and providers with initiating verbal and written coverage determinations and appeals. - Records calls accurately within the pharmacy call tracking system. - Maintains established pharmacy call quality and quantity standards. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. - Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications - At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-28.8 hourly 42d ago
  • Pharmacy Representative

    Molina Healthcare Inc. 4.4company rating

    Las Cruces, NM jobs

    JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties * Handles and records inbound/outbound pharmacy calls from members, providers and pharmacies in accordance with departmental policies, state regulations, National Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with clerical tasks and other day-to-day pharmacy call center operations as delegated. * Effectively communicates plan benefit information, including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with initiating verbal and written coverage determinations and appeals. * Records calls accurately within the pharmacy call tracking system. * Maintains established pharmacy call quality and quantity standards. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews (CMRs)through pre-work up to case preparation. * Proactively identifies ways to improve pharmacy call center member relations. Required Qualifications * At least 1 year related experience, including call center or customer service experience, or equivalent combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications * Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. * Health care industry experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-28.8 hourly 21d ago
  • Pharmacist - Pharmacy

    Presbyterian Healthcare Services 4.8company rating

    Pharmacist job at Presbyterian

    Presbyterian is seeking a motivated and detail-oriented Pharmacist to join our team. The Pharmacist interprets and evaluates orders and prepares/dispenses medications to patients and staff while monitoring the safety and efficacy of the prescribed drugs. The Pharmacist must have excellent communication skills since they often work closely with doctors and other healthcare professionals to ensure that patients receive the right medication and dosage for their medical conditions. Type of Opportunity: Full Time (1.0 FTE/40 hours per week) Work Schedule: Nights Sign on bonus available for qualified candidates. How you grow, learn and thrive matters here. * Educational and career development options, including tuition and certification reimbursement, scholarship opportunities * Wearable duress alarm technology (a wearable badge that allows staff to quickly and discreetly call for help when safety is a concern) * Shift differentials for nights and weekends * Differentials for higher education, certifications and various lead roles * Malpractice liability insurance * Loan forgiveness through the New Mexico Higher Education Department * EPIC electronic charting system Qualifications * Bachelor's degree * Education specialization: Pharmacy * Registered Pharmacist * Licensed New Grads are welcome to apply. * Responsible for on-call, weekend, night, and/or holiday coverage as required on a rotating basis. * Less than one year experience in pharmacy practice preferred. Responsibilities * Maintains established departmental policies and procedures, objectives, PI program, safety, environmental, and infection control standards. * Compounds, packages, labels, and dispenses medications. * Advises patients and families on the use of medications including dosage, side effects, and composition. * Maintains professional growth and development through participation in educational programs, current literature, in-services, and workshops. * Monitors medication use for appropriateness. * Oversees the activities of technicians, interns, and students. * Participates in education programs for pharmacy staff, attends meetings as required, and participates on committees as needed. * Participates in training pharmacists, technicians, students, and residents. * Consults with and advises healthcare providers regarding optimal and cost-effective utilization of drugs. * Performs other functions as required. Benefits We're all about well-being, starting with yours.Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more. Learn more about our employee benefits. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses. Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $77.92/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
    $77.9 hourly Auto-Apply 60d+ ago

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