Pharmacist

• Receives electronic prescriptions, weekly batches or refill requests and accurately and efficiently fills the prescriptions under the direction of the Pharmacist
• Performs pharmacy tasks such as handling, counting, mixing, and packaging medications
• Assists in entering minor edits to record correct dispensing quantity and manufacturer NDC used to dispense prescription order
• Performs reclamation duties
• Uses pharmacy software to check and/record data about prescriptions
• Acts as a liaison between our customers and their providers and our pharmacy
• Establishes and maintains patient profiles, including lists of medications taken by individual patients
• Uses pharmaceutical technician expertise to ensure compliance, efficiency, and quality of operations
• Participates in company quality initiatives, recognizing opportunities for improvements and reporting quality assurance issues
• Secures information in accordance with the privacy and security guidelines of the Company and applicable regulations such as HIPAA
• Provides enrollment support for new PACE enrollees
• Communicates pharmacy benefit information to network pharmacies contracted with facilities where CK PACE participants reside
• Coordinate facility discharges to assure medication reconciliation is complete and delivery to home is back in place
• Provides help desk support to network pharmacies
• Education PACE staff regarding CK and network pharmacy processes for facility participants.

Pharmacy Technician

• Support the pharmacy team in delivering operational and service excellence
• Assist patients and customers to deliver an exceptional experience
• Ensure pharmacy operations run smoothly, prescriptions are filled promptly and accurately
• Deliver additional patient health care services where allowable by law

• Assist in accurately reading, interpreting and entering prescriptions into the computer system
• Calculate doses and assignment of directions and accept proper insurance payment in a timely fashion
• Route incomplete or unclear prescriptions to the prescriber for clarification
• Enter incomplete prescription information once clarification has been obtained
• Assist with inbound phone calls and interact with customers
• Provide education and maintain the company's reputation for high-quality service
• New patient enrollment, verification of insurance coverage and perform benefit investigations
• Process medication orders for both new and existing patients
• Assess and identify routine issues for appropriate escalation to a pharmacist

Pharmacy Care Technician

• Provide executive leadership presence with key Pharmacy leaders to maintain tight strategic alignment
• Define a multi‑year technology vision and roadmap to deliver the Pharmacy of the Future
• Lead the evolution to AI-first, cloud-first, and agentic architectures
• Create & deliver new solutions by helping partners to see the art-of-the-possible
• Reset how teams work by shifting from project-centric delivery to outcome-driven, product and capability-oriented operating models
• Drive 'Lead to One' execution by aligning org design, funding models, metrics, and incentives to enterprise and Pharmacy outcomes
• Own delivery discipline at scale in partnership with peers
• Integrate patient and provider experience into the core AI pharmacy architecture
• Develop and lead a world-class global workforce with strong talent mobility

VP, Pharmacy – Technology Transformation

• Provide consultations through the patient's preferred method of communication (text, app messaging, email, or phone)• Perform initial assessments by gathering/reviewing chart notes to determine appropriateness of prescribing patterns• Perform clinical check-ins to monitor adherence, efficacy, adverse reactions, and drug interactions• Identify patients in need of clinical interventions and work collaboratively with providers to provide therapeutic recommendations resulting in improved patient outcomes• Ensure transition of care by transferring out prescriptions to appropriate pharmacies in situations where Alto is unable to fulfill a patient’s prescription• Being responsible for communicating prescription statuses to patients and providers• Work closely with Specialty Operations to provide quality care through the following:• Maintain an in-depth understanding of pharmacy billing including but not limited to Medicaid, Medicare, ADAP, commercial insurance, and foundation assistance programs to help troubleshoot patient cost barriers• Proactively identify and communicate areas of concern regarding scheduling/delivery procedures• Develop and provide drug information material designed to enhance Specialty Operations’ performance• Stay abreast of relevant and evolving regulatory and industry standards, ensure that appropriate action is initiated, and communicate these trends to applicable personnel• Work interactively with a local and/or dispersed team to achieve company business and compliance goals/objectives

Patient Care Pharmacist – Short Term Assignment

• 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

• Responsible for all telephonic interaction with members, physician office staff, pharmacies and internal stakeholders for Pharmacy eligibility, coverage determination, and/or claim issues
• Engagement with physicians & pharmacists to conduct effective interventions through clinical therapeutic interchange to facilitate formulary compliance, optimize generic dispensing, and consistency with the current plan design
• Capture accurate and comprehensive clinical information for Prior Authorization requests from physicians and/or medical office staff to allow for clinical review and medical necessity determination
• Responsible for satisfying all departmental customer service quality metrics while ensuring that all DMAHS and DOBI required regulatory turnaround times are consistently satisfied
• Process complaints, appeals, grievances, executive inquiries and compliance related issues
• Responsible for identifying via interactions with members and providers, instances of potential fraud, waste, and abuse and resulting internal referrals that are necessary
• Provide recommendations to increase efficiency, accuracy and productivity in the department
• Process ad hoc request for information or reports from stakeholders
• Accountable for independent and group learnings to ensure understanding of pharmacy services procedures and workflows
• Assist in the day-to-day business functions of the pharmacy department as well as the Medication Therapy Management program
• Provide support to various clinical programs within the pharmacy department

Pharmacy Specialist I

• Helps develop and implement Monogram’s medication therapy management (MTM) program which will ensure appropriate use of medication management resources
• Performs timely written member medication reconciliations and drug therapy action plans for all Monogram members and communicate them to Monogram clinical staff and treating nephrologists, primary care physicians and other providers
• Conducts telephonic consultations with medical providers when medication changes appear necessary
• Speaks with members about medication use concerns
• Works collaboratively with clinical (e.g. nurse and social worker) care manager operations personnel to integrate medication management into Monogram’s overall care model
• Ensures that field clinicians are executing on MTM policy and procedures
• Drives meaningful medication interventions that result in medical providers’ and members’ adhering to evidence-based medication guidelines
• Reviews member care reports, clinical notes and other medical records as needed for medication action plan development, targeted clinical outreach programs and quality assurance purposes
• Serves as a pharmacist resource for Monogram field clinicians regarding medication use and Monogram MTM resources
• Assists with the delivery of MTM training sessions aimed at building a standardized and effective MTM program for Monogram clinical staff
• Monitors important medication availability and use trends for populations under Monogram’s care management
• Stays current with evidence-based prescribing for individuals with kidney disease
• Participates in external and internal interdisciplinary care team case rounds or meetings and produce MTM related documentation to be shared with appropriate treating providers
• Implements medication optimization processes that meet the needs of managed care organizations and their members

Clinical Pharmacist

• 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

• Operate within pharmacist-led clinical programs focused on chronic disease, quality improvement, and medication optimization.
• Activate on provided lists of eligible patients by outreaching, enrolling, and engaging patients. Maintain engagement through education, outreach, and follow-up.
• Conduct Medication Reconciliation, Medication Therapy Management (MTM), and Comprehensive Medication Reviews (CMR).
• Provide telephonic patient education on medication use, adherence, self-management, and escalation of care.
• Provide specific actionable medication recommendations and collaborate with providers, using technology and direct communication, to support practice adoption and medication management.
• Support other clinical programs to provide periodic consultation on pharmacy related issues affecting patients
• Drive medication adherence to address quality gaps
• Collaborating with the IDT—which includes primary care physicians, health coaches, and nursing staff—to develop patient-specific clinical action plans, reconcile medications, and make necessary adjustments to medications.
• Accelerate adoption of clinical insights by providers by driving uptake of actionable drug-related recommendations.
• Provide clinical feedback to enhance decision support logic, usability, and impact.
• Collaborate with Regional Medical Officers, Market Medical Directors, Practice Transformation Managers, care teams, and practices.
• Support consistent clinical standards, workflows, and messaging across markets.
• Support ideation and development of initiatives related to specialty medications, high-cost drugs, and pharmacy optimization programs.
• Partner with pharmacy and medical leadership on drug strategy aligned with value-based care goals.
• Document all clinical activity accurately and in accordance with state and federal regulations and HIPAA requirements, using provided platforms and technologies
• Serve as a pharmacy information resource for providers and internal clinical teams.
• Remain current on clinical guidelines, quality measures, and pharmacy best practices.

• 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

See all jobs on JobTailor

Pharmacy Technician

Pharmacy Technician

Pharmacy Care Technician

VP, Pharmacy – Technology Transformation

Patient Care Pharmacist – Short Term Assignment

Pharmacy Business Consultant

Pharmacy Specialist I

Clinical Pharmacist

Prior Authorization Pharmacist

Prior Authorization Pharmacy Technician

Clinical Pharmacist

Pharmacy Technician – Prescription Routing, Claims Support