Pharmacist

• Provide Comprehensive Medication Management (CMM) in collaboration with hub-based and virtual clinical care teams and provide other pharmacist support services as needed.
• Contribute in the development of a medication management action plan to achieve member self-management goals and clinical outcomes, with measurable parameters and timeline for monitoring and follow-up.
• Communicate and work collaboratively with Cityblock and external providers belonging to member care team to ensure all clinical interventions and encounters are aligned with medication-related goals, and conduct ongoing assessments and refinements to care plan necessary to promote goal attainment.
• Provide direct support to clinical team members for all general drug information, dosing, interaction/adverse effect avoidance questions or member-specific needs.
• Participate in staff education through presentation of medication management in-services, development of educational tools for clinical and non-clinical team members, and training/coaching/facilitating all roles on consistent maintenance of a member’s best possible medication list care management platform, Commons, as well as post-discharge med reconciliation process for providers.
• Help develop medication management and disease state-specific clinical pathways/protocols, with the eventual goal of transitioning to collaborative practice agreements (CPA) with Cityblock physicians, permitting pharmacist to perform member assessments, order laboratory tests, and initiate or adjust medications per protocol to improve the efficiency and effectiveness of team-based care.

Ambulatory Care Clinical Pharmacist – OH, MI, IL

• Responsible for screening orders, specializing in research, review and entry of prescription overrides
• Ensure patients receive their correct prescriptions in a timely manner
• Direct questionable prescriptions to the prescriber for clarification
• Meet specified production and quality standards as defined by the management team
• Perform other pharmacy functions as required

Pharmacy Technician – Non Clinical Diverts

• Collaborate with a high performing, multidisciplinary team of professionals across multiple functions to conduct comprehensive medication reviews (CMRs) for high-risk populations
• Conduct assessments of drug interactions
• Identify therapeutic duplications
• Evaluate renal and hepatic dosing adjustments
• Address evidence-based gaps in care
• Support STAR-related pharmacy initiatives
• Identify barriers to medication affordability and adherence

Clinical Pharmacist – MTM

• Remote order entry and CPOE order evaluation and verification
• Assure acquisition or renewal of all pharmacy staff licenses
• Performs as staff pharmacist as needed
• Physician and nursing consultations
• Clinical medication dosing services
• Review and monitoring of profiles and lab values for therapeutic outcomes
• Coordinates access to medications according to facility policy and procedures, and in compliance with state and federal laws and regulations.

PRN Pharmacist

• Directing the development, maintenance and on-going oversight for clinical and operational programs and processes for Enterprise Pharmacy Government Programs of Medicare and Medicaid.
• Includes overseeing CMS Stars and Medicaid Quality Withhold Programs, Medicare and Medicaid operational and reporting activity.
• Monitoring pharmacy cost and utilization trends.
• Developing and maintaining reimbursement methodologies for pharmaceuticals.
• Oversight of contracted pharmaceutical benefit managers (PBM).
• Collaborating with management and professional staff within HCSC and with external health care providers to improve quality of healthcare, optimize health outcomes, and improve the cost of care.

Clinical Pharmacy Manager

• Serve as an instructor and subject matter expert
• Offer specialized consultation to other business coaching team members
• Collaborate with assigned Business Coaching Coordinator
• Enhance customer retention and engagement
• Execute complex processes and engage in client-facing situations
• Continuously maintain and update coaching activities within the CRM system
• Compile pharmacy data to prepare necessary reports
• Drive results by aligning opportunities with customer needs
• Oversee all aspects of programs
• Identify potential weaknesses within pharmacy operations
• Work closely with Business Coaching Coordinator to assess customer needs
• Guide in-store implementations
• Develop and maintain a strong understanding of the independent retail pharmacy market
• Provide leadership with insights on industry intelligence
• Create and implement new concepts

Pharmacy Business Consultant

• Work per diem, Monday- Friday 7:30am- 4:00pm as needed, this position will be mostly remote once training is completed.

Retail Pharmacy Technician

• Lead the Medication Therapy Management (MTM) team
• Responsible for the strategy, planning oversight, and monitoring of outcomes
• Collaborate with leaders across the Humana enterprise, HPS executive leaders
• Extensive engagement representing Humana with external partners
• Optimize the MTM services offered to Humana members

Associate Director, Clinical Pharmacist

• Prepare and dispense drugs, supplies, and equipment
• Lead clinical assessments, patient education, care planning, and outcome monitoring
• Provide drug information and consultations to patients, families, physicians, and healthcare professionals
• Complete documentation per policy to maintain thorough and accurate clinical records

Pharmacist – Home Infusion

• Assist pharmacist under direct supervision in the provision of pharmaceutical care
• Enter patient information accurately into pharmacy computer system
• Perform calculations needed for prescription input and dispensing
• Offers patient counseling by a pharmacist
• Follow department procedures for maintaining drug and supply inventory
• Respond to phone call inquiries and walk-up service requests
• Perform select assigned tasks such as facilitating prior authorizations

Pharmacy Technician – Retail

• Support the pharmacy team in delivering operational and service excellence
• Assist pharmacy team to ensure that pharmacy operations run smoothly
• Operate as part of the pharmacy team through consistent application of Standard Operating Procedures (SOPs), best practices, and effective communication
• Complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s Board of Pharmacy guidelines
• Deliver additional patient health care services (e.g., immunizations, point-of-care testing, and voluntarily staffing offsite clinics)

Pharmacy Technician

• Travel throughout your territory (approx. 80% travel, 50% overnight)
• Visit independent pharmacies regularly to grow sales and engagement
• Prospect for new business opportunities
• Build long-term relationships with pharmacy owners and staff
• Deliver business reviews and growth strategies in person
• Identify opportunities to increase participation and purchases
• Manage your territory pipeline and report results

Pharmacy Business Advisor

• Review and render decisions on authorizations and appeals for specialty, non-specialty, and physician administered drugs
• Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations
• Participate in clinical quality audits and inter-rater reliability testing
• Provide internal team support for escalations and questions
• Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals by members and providers.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Prior Authorization Pharmacist

• Use Oscar and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests
• Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information
• Collect relevant medical information (via telephone, fax, and portal) and apply the appropriate PA criteria, clearly documenting all communication and decision making
• Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review
• Communicate oral and written prior authorization outcome notifications that comply with standards and requirements for content and accuracy
• Compliance with all applicable laws and regulations
• Other duties as assigned

Prior Authorization Pharmacy Technician

• Manage pharmacy orders via phone, fax, or web.
• Resolve customer inquiries, returns, and shipment issues.
• Coordinate with distribution and manufacturing teams.
• Maintain accurate documentation and compliance records.
• Communicate professionally with patients and healthcare providers.

Certified Pharmacy Technician – CPhT

• Troubleshooting electronic, faxed, and verbal prescriptions via routing to appropriate channels into pharmacy systems
• Review and update patient insurance using payer portals and phone resources
• Determining appropriate situations for a prior authorization (PAs) need via payer-specific tools; troubleshoot denials and escalations
• Utilize reroute best practices for orders falling outside normal workflow, including orders with state changes, insurance exceptions, pharmacy rejections, or failed transfers
• Navigate operational platforms (e.g., BestRx, Ops Dash, Partner Dash, RelayHealth, etc.) and vendor systems effectively
• Follow reroute protocols for specific tags including: non-contracted pharmacies, state shipping changes, PP send-backs, transfer not received, and more
• Proactively document process notes with clear routing details, claim updates, and actions taken
• Communicate with partner pharmacies, provider offices, and insurance carriers to resolve issues or clarify documentation
• Collaborate with At-Risk, Partner Management, and PPM teams to escalate or flag orders based on system outages, stock issues, or policy refusals
• Maintain productivity in the Reroute queue even during extended call hold times (e.g., multitask during insurance calls)
• Ensure all patient, prescriber, and partner communications are clear, professional, and aligned with Phil’s standards of care

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