Pharmacist

• Oversees pharmaceutical care, including retrieving and evaluating biomedical literature and designing medication therapy regimens
• Uses effective patient education techniques to provide counseling to patients and caregivers, including information on medication therapy, adverse effects, compliance, appropriate use, handling, and medication administration
• Designs, recommends, monitors, and evaluates patient specific pharmacotherapeutic regimens based on relevant biomedical literature
• Implements recommendations effectively and utilizes policies and procedures and documents in the appropriate format.
• Reviews and accurately interprets medication orders and prescriptions
• Participates in the management of medical emergencies when applicable
• Actively supports department medication safety and quality improvement activities
• Performs quality assurance and performance improvement of the medication use system as appropriate
• Collaborates with the healthcare team to manage formulary adherence and the medication-use process
• Practices in compliance with organization’s policies and procedures, as well as local, state, and federal regulations
• Serves as preceptor for pharmacy students, residents, and healthcare learners as assigned

Clinical Pharmacist

• Acts as a liaison between Finance, Analytics, IT and Pharmacy
• Focus on understanding data content and the business logic behind all data transformation for reporting
• Develop expertise in the data and systems leveraged internally and externally for the Pharmacy Department
• Gather requirements, perform analysis, support the development and testing of processes
• Understand and document the applications, data and associated technologies for the Pharmacy Department

Senior Pharmacy Performance Specialist

• Managing the selection and utilization of pharmaceuticals
• Supporting core clinical programs such as DUR, DIS and formulary management
• Researching and synthesizing detailed clinical data related to pharmaceuticals
• Preparing and presenting therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee
• Reviewing and approving or denying coverage for pharmaceuticals based on medical necessity criteria
• Serving as a clinical resource to other pharmacists
• Providing dosage conversion and clinical support for therapeutic interventions
• Preparing information for network physicians

• assist in accurately reading, interpreting and entering prescriptions into the computer system
• calculation of doses and assignment of directions and accepting proper insurance payment in a timely fashion
• routing incomplete or unclear prescriptions to the prescriber for clarification
• entering incomplete prescription information once clarification has been obtained
• assist with inbound phone calls; interact with customers and cross functional team to answer questions, solve problems, provide education
• maintain our company’s reputation for high-quality service
• new patient enrollment, verification of insurance coverage and perform benefit investigations and processing of medication orders

Pharmacy Care Technician

• Oversees pharmaceutical care, including retrieving and evaluating biomedical literature and designing medication therapy regimens
• Uses effective patient education techniques to provide counseling to patients and caregivers
• Designs, recommends, monitors, and evaluates patient specific pharmacotherapeutic regimens based on relevant biomedical literature
• Implements recommendations effectively and utilizes policies and procedures and documents in the appropriate format
• Reviews and accurately interprets medication orders and prescriptions
• Participates in the management of medical emergencies when applicable
• Actively supports department medication safety and quality improvement activities
• Performs quality assurance and performance improvement of the medication use system as appropriate
• Collaborates with the healthcare team to manage formulary adherence and the medication-use process
• Assists in the acquisition of non-formulary, compassionate use, and investigational medications
• Practices in compliance with organization’s policies and procedures, as well as local, state, and federal regulations
• Prepares, dispenses, and oversees the proper storage and handling of medications in accordance with best practice, policies and state and federal regulations

Clinical Pharmacist, Virtual Pharmacy Services

• 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

• Monitor FDA-approvals, drug manufacturer pipelines, and assess drug utilization reports
• Develop and execute the organization's drug formulary
• Develop pharmacy utilization management policies
• Maintain compliance with federal, state, and other mandates
• Write drug monographs for committee review
• Develop and implement management programs including prior authorization, dose and duration edits, quantity limits, step-care edits, and others
• Provide guidance to more junior team members
• Participate in evaluating, implementing, and monitoring pharmacy benefit-focused federal and state legislation
• Develop, execute, and monitor pharmacy-specific strategic initiatives
• Present recommendations to leadership

Senior Pharmacist – Strategy

• Synthesize evidence on drug comparative effectiveness, adverse effects, safety, patient adherence and preferences, unmet need, and therapeutic advances from existing literature, including randomized controlled trials, systematic reviews and network meta-analyses, FDA labels and clinical practice guidelines
• Help design, conduct, and interpret studies to understand drug utilization patterns overall and in subpopulations, using claims and other data sources
• Identify clinically relevant outcomes, endpoints, and surrogate markers, and specify appropriate subgroups relevant to clinical practice guidelines
• Provide clinical expertise on drug formulations, dosing logic, drug characteristics, therapeutic alternatives to new and existing indications, and contribute clinical coding expertise, including identifying off-label use
• Serve as a subject-matter expert on drug pharmacology, classification systems, drug compendia, and use of publicly available and commercial drug databases
• Conduct and report on interviews of clinical experts (physicians) to understand current real-world treatment patterns and considerations in the use of select drugs
• Support development of value frameworks, formulary recommendations, and coverage policies (tier placement and utilization management) for public and private payers
• Collaborate with multidisciplinary research teams including health economists, physicians, biostatisticians, policy analysts, programmers, and clients
• Translate findings into policy-relevant deliverables, such as reports, briefs, presentations, and publications

Pharmacist – Real-World Evidence, Health Policy Consulting

• Demonstrates comprehensive knowledge of current pharmacotherapeutic principles, medical terminology, pathologies, disease state and population management, age appropriate therapy, and other information as related to medical and/or pharmaceutical care management.
• Work with Sentara Health Plan (SHP) members to close medication-related gaps in care
• Work on the referrals from the team
• Counseling members on their medication therapy

Clinical Pharmacist – Medicare STARS

• responsible for the interpretation and data entry of moderately complex prescriptions
• prior authorization processing
• troubleshooting adjudication issues
• verifies member information and inputs data for the pharmacists
• educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs
• processes prior authorization requests from physicians, offices and ensures compliance with Medicare requirements
• informs relevant parties of all prior authorization determinations
• provides resolution to grievances and appeals issues
• responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits
• generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports
• maintains record keeping of prior authorizations, rebates, and monthly reports

Pharmacy Tech II

• Ensure accurate entry of orders
• Maintain security of the pharmacy
• Adhere to required delivery schedules
• Verify orders entered by technician staff for accuracy
• Check for completeness and precision of all new and refill labels and orders
• Check for content and accuracy of all drug packaging and labeling
• Preparation and/or supervision of sterile IV drug products or solutions, if required
• Assist in maintaining a perpetual inventory for schedule II drugs
• Provide evening, weekend, and holiday coverage during scheduled rotation based on the needs of the business
• Follow all applicable state and government regulations including HIPAA
• Other duties as assigned (these vary by location)

Dispensing Pharmacist – Long Term Care

• Deliver compassionate care to patients every day
• Manage all assigned pharmacy workstations and tasks to support the team’s ability to fill patient prescriptions promptly, safely, and accurately
• Provide caring service that exceeds customer expectations
• Complete an extensive CVS Pharmacy Technician Training Program and satisfy all registration, licensing and certification requirements according to your State’s Board of Pharmacy guidelines
• Work in compliance with federal, state, and local laws and regulations, ensuring all medication needs are met and regulatory compliance standards are upheld
• Demonstrate ethical conduct and maintain patient confidentiality at all times

Pharmacy Technician

• Lead a team of account executives, driving strategic and operational excellence
• Build and maintain consultative partnerships with senior client stakeholders
• Oversee budget, revenue goals, staffing, and resource allocation
• Develop and implement standard operating procedures for client service
• Manage contract negotiations and pricing for new business and renewals
• Facilitate strategic discussions with clients to review service performance

Director, Pharmacy Client Management

• Provide integrated support to patients and physicians by providing a "hands-on" approach to improve the quality of patient care. • Develop personalized relationships with patients and prescribers to improve medication adherence and promote evidence-based care. • Reviewing and interpreting clinician's patient care note/assessments for supportive clinical data needed for prior authorization approvals and development of care plan recommendations. • Develop and refine disease and drug specific clinical protocol to maximize patient adherence and promote evidence-based cost-effective care. • Monitor on-going patient adherence (PDC reports, patient assessment data, and mobile platform data) across all sites and disease categories with focus on oncology and other specialty specific disease states. • Evaluation of EMR to review: drug and disease interaction, medication selection, labs/vitals, allergies, RX orders/renewals and direct MD communication, and other relevant information important to maximize medication adherence and optimize patient outcomes. • Recommending alternative therapeutic drug regimens and disease specific treatments according to guidelines as appropriate. • Monitor and evaluate therapies for side effects or other medication related issues, recommend drug therapy changes to prescribers as appropriate. • Medication therapy management (MTM): including reviewing and monitoring of medication regimens, advising clinicians on evidence based therapy as indicated, documenting interventions; assessing patient adherence rates. • Clinical interventions including but are not limited to comprehensive pharmacist consultation, motivational interviewing/coaching, drug regimen optimization, medication reconciliation, medication lists or reminders, medication synchronization, coordinate home nurse visits, transitions between liaison/PSC, use of mobile app or other technologies. • Productivity monitoring and reporting weekly stats for growth development. • Overseeing tech's daily activities and verification for accuracy on: delivery coordination slips, prior authorizations submitted, ongoing PA log activity and proactive management care utilization within each specialty as per protocol. • Identifying and resolving insurance related issues, recognizing situations where financial assistance can be applied. • Supervising communication of support personnel compliant with HIPPA rules and regulations; • Maintaining current registration and all remote pharmacist activity to comply with local, state and federal drug laws as regulated by each state board of pharmacy and the DEA. • Direct communication with other health professionals as necessary regarding patient care; • Develops own knowledge by participating in education programs; training pharmacy staff, students, interns, externs, and health care professionals; • Manage, organize, and update relevant data using database applications; • Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards; • Assist with research projects and peer reviewing articles as needed. • Identify trends, resolves problems; recommend improvements; implements change; • Actively participates in process improvement initiatives; • Protects organization's value by keeping information confidential; • Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations; • Willing to do whatever is necessary for the betterment of the Company; • Other duties as assigned;

Clinical Pharmacist, North Carolina License Required

• Provide pharmaceutical care services including monitoring, preparation, dispensing of patient medication therapy
• Review and monitor patient medication therapy
• Advise patient care team on medication therapy enhancements
• Prepare, label, and dispense medications in accordance with prescriptions
• Maintain records of dispensing and comply with laws and regulations

Clinical Pharmacist – PRN

• Utilizing data insights, identify prescriptions that are delayed or stalled and take appropriate action.
• Establish, develop, and maintain working relationships with regional network specialty pharmacies, their leadership, and staff.
• Inform pharmacists and their staff on patient access and affordability programs that could be beneficial to patients.
• Work with HCPs to support complete, accurate and timely prescription submissions to Network specialty pharmacies or health plans, to minimize delay in therapy.
• Serve as a Network Specialty Pharmacy partner within assigned geography and communicate with stakeholders in a timely manner.
• Maintain a strong working relationship with sales and sales leadership.
• Assist the Field Reimbursement and Patient Services Team in identifying opportunities for continuous process improvements through root cause analysis and identifying ongoing training needs.
• Conduct needs assessment and provides appropriate education for HCPs (i.e., CoverMyMeds, Prior Authorization (PA) process, pharmacy process).
• Coordinate cases with patient support service program representatives (HUB) to ensure patient and physician needs are being addressed in a timely manner.
• Educate physician office staff on the use of patient assistance programs and call center support services, including web-based provider programs.
• Attend POAs and Regional conference calls, providing education, training, and feedback on the positioning of our network pharmacies and the current market access environment, to ensure a clear path for HCP and the patient.
• Provide timely information on patient access to the National Account Directors so they are informed and up to date on pharmacy claims and PA process for PBMs and payers.
• Collaborate with the Field Reimbursement and Patient Services Team on patient cases that need additional support and training activities with network pharmacies.
• Maintain the highest level of ethical obligations and ensure that all activities are complied with applicable laws and regulations.
• When called on for business travel manage personal travel schedule and travel arrangements.
• Prepare and submit appropriate expense reports in a timely fashion.

Pharmacy Experience Associate

• 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

• Optimize patient outcomes through telephonic interventions
• Focus on the tactical execution of medication management services, including polypharmacy, adherence, and pharmacotherapy optimization
• Counsel patients via telephonic outreach on medication adherence, address any medication related problems such as adherence barriers, polypharmacy, or high risk medication use, and make appropriate evidence-based recommendations to patients and Practice Care Teams
• Perform focused clinical chart reviews as needed to inform patient interventions
• Obtain and document patient commitment to medication adherence and address barriers in real time
• Escalate complex clinical cases to prescribers or interdisciplinary teams as appropriate
• Meet and sustain performance goals (e.g., STARs, HEDIS)
• Collaborate with Physicians, clinical and administrative staff to optimize the Medication Management workflow and patient experience
• Proactively identify gaps in medication management through patient interactions and translate patient insights into targeted recommendations that drive improvements in practice operations and clinical workflows
• Participate in the design, implementation, and evaluation of pilot programs or process changes (“test and learn”) within the outreach model
• Serve as a clinical subject matter expert, leveraging clinical pharmacy expertise to support organizational objectives and adapt to evolving healthcare needs
• Develop and maintain standardized resources, educational tools, and clinical protocols to support improved medication outcomes and performance on quality measures (e.g., STARS, HEDIS) for practices, clinicians, and patients

Clinical Pharmacist, Pharmacy Outreach

• 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

Clinical Pharmacist

Senior Pharmacy Performance Specialist

Clinical Pharmacist

Pharmacy Care Technician

Clinical Pharmacist, Virtual Pharmacy Services

Patient Care Pharmacist – Short Term Assignment

Senior Pharmacist – Strategy

Pharmacist – Real-World Evidence, Health Policy Consulting

Clinical Pharmacist – Medicare STARS

Pharmacy Tech II

Dispensing Pharmacist – Long Term Care

Pharmacy Technician

Director, Pharmacy Client Management

Clinical Pharmacist, North Carolina License Required

Clinical Pharmacist – PRN

Pharmacy Experience Associate

Prior Authorization Pharmacist

Prior Authorization Pharmacy Technician

Clinical Pharmacist, Pharmacy Outreach

Pharmacy Technician – Prescription Routing, Claims Support