Pharmacist

• Manages the lifecycle of payor contracts including review, interpretation, implementation, amendments, and renewals.
• Serves as subject matter expert on contract terms including reimbursement methodologies, fee schedules, carve-outs, drug-level pricing, site-of-care requirements, and network participation.
• Tracks contract expirations, renewals, and amendments to ensure uninterrupted access and compliance.
• Analyzes reimbursement methodologies (AWP, WAC, ASP, MAC, per diem, case rates, nursing fees, supplies, admin fees) and identifies reimbursement risks, underpayments, and revenue leakage.
• Partners with finance and revenue cycle to resolve reimbursement discrepancies and payment disputes and supports forecasting, margin analysis, and payor profitability reporting.
• Translates contract terms into operational requirements for pharmacy systems, billing platforms, and claim adjudication logic and coordinates with IT and pharmacy operations to ensure accurate setup of pricing and payor-specific rules (including NDC requirements, J-codes, modifiers, and site-of-care billing logic).
• Supports payor mapping tied to BIN/PCN, NCPDP, NPI, and taxonomy configurations.
• Ensures contracts comply with federal and state regulations including CMS, Medicare Part B and D, Medicaid, 340B, and anti-kickback requirements; maintains audit-ready documentation; and supports internal/external audits.
• Acts as the primary contract resource for internal teams; provides contract education to support accurate billing and payor compliance; and supports payor escalations, access issues, and network participation inquiries.

Payor Contract Manager – Infusion

• Performs a variety of clerical, distributive, technical and data gathering duties in order to provide medications to patients and support pharmacists
• Develops competence in dispensing and delivery of medications
• Develops competence in preparing non-sterile products following USP, state, and federal recommendations
• Develops competence in entering medication orders in the computer system and/or processing medication requests via the computer system
• Develops competence in managing phone calls from customers and team members such as nurses, physicians or patients
• Complies with legal, regulatory, accreditation standards

Pharmacy Technician I – Discharge Medication Pharmacy

• Provide daily support to the Trillium pharmacy team
• Coordinate work with the Pharmacy Benefit Manager (PBM) and the State Department of Health Benefits (DHB)
• Assist in performing medication reconciliations under supervision
• Support pharmacy team in clinical programs including Medication Reconciliations
• Responsible for data analysis and reports
• Assist Trillium team members with pharmacy related information/projects
• Assist with pharmacy provider network outreach and communication
• Handle member inquiries related to formulary/preferred drug list (PDL) process or access issues

Pharmacy Technician

• Responsible for the direct daily supervision of pharmacy service representatives (PSRs)
• Provide proactive compliance and ordering calls for all medications dispensed by CVS/specialty Pharmacy Network
• Guidance and direction to staff
• Direct daily workflow, schedule preparation and management
• Ensure adherence to standard operating procedures
• Interviewing/hiring process, staff training, and performance monitoring
• Conduct audits, review metrics, and prepare scorecards

Supervisor, Specialty Pharmacy Services

• Assist the Clinical Pharmacy Director in providing clinical oversight for the development and implementation of the pharmacy program plan for clinical services
• Evaluate medication reconciliations and provide Medication Management referrals, education, and outreach to Care Management, providers, and members
• Assist pharmacy team members with pharmacy related information/projects
• Support/perform educational activities for Trillium colleagues, providers, and members when necessary
• Assist in the development and maintenance of cost-effective pharmacy programs, including management of the formulary; utilization management programs; and responding to internal questions

Clinical Pharmacist

• 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

• Responsible for the design, configuration, and quality assurance of prior authorization (PA) criteria
• Ensures clinical intent is accurately translated into compliant, efficient system logic through structured QA/QC and validation processes
• Collaborates with internal teams and external clients to support delegated PA services and drive system optimization
• Build decision trees and question sets from PA criteria for prior authorization review
• Perform comprehensive quality control (QC) review of decision trees, questionnaires, and authorization logic to ensure alignment with clinical intent, regulatory requirements, and business rules
• Conduct quality assurance (QA) validation of configured criteria and decision paths
• Ensure PA questionnaires are configured with the appropriate authorization parameters for approval
• Collaborate with external clients for delegated clinical PA systems services
• Manage setup, contracting, and relationships with prior authorization external vendors
• Mapping of prior authorization member and prescriber letter templates in the prior authorization system
• Validate that denial rationales, approval language, and conditional messaging accurately reflect clinical criteria and system outputs
• Creation and maintenance of Commercial and Government denial verbiage templates
• Develops and maintains policies and procedures for creation and maintenance of clinical criteria questions and letter templates
• Establish and maintain QA/QC standards, documentation, and audit processes for decision trees, criteria configurations, and letter templates
• Identify PA reporting needs and collaborating with appropriate stakeholders to develop reports
• Respond to requests for clinical criteria from members and prescribers
• Attend formulary meetings and presentations

Prior Authorization Systems 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
• Collaborates with the healthcare team to manage formulary adherence and the medication-use process
• Prepares, dispenses, and oversees the proper storage and handling of medications
• Serves as preceptor for pharmacy students, residents, and healthcare learners as assigned

Clinical Pharmacist – Virtual Pharmacy Services

• 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
• Prepare and/or supervise sterile IV drug products or solutions, if required
• Assist in maintaining a perpetual inventory for schedule II drugs
• Knowledge of DEA and state law with regards to controlled drug dispensing
• 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

Dispensing Pharmacist, Long Term Care – Part Time

• Work in a leading retail pharmacy company
• Deliver compassionate care to millions of patients every day
• Manage all assigned pharmacy workstations and tasks
• Support the team in filling patient prescriptions accurately and safely
• Complete an extensive CVS Pharmacy Technician Training Program
• Satisfy all registration, licensing and certification requirements
• Maintain patient confidentiality and ethical conduct at all times

• support the pharmacy team in delivering operational and service excellence within your store
• assist the pharmacy team to ensure that pharmacy operations run smoothly, prescriptions are filled promptly, safely, and accurately
• operate as part of the pharmacy team through consistent application of Standard Operating Procedures (SOPs)
• complete basic inventory activities, accurately putting away medication deliveries and completing cycle counts
• contribute to a high-performing team, embracing a growth mindset, and being receptive to feedback
• deliver additional patient health care services (e.g., immunizations, point-of-care testing)
• monitor for and respond to adverse reactions; report adverse reaction events per public health requirements

• Lead analytics to evaluate pharmacy and clinical programs
• Assess performance of existing programs
• Size new opportunities
• Monitor the effectiveness of ongoing operations
• Develop clear, structured presentations and lead consultative discussions with stakeholders
• Partner cross-functionally to develop, socialize, and influence recommendations

Senior Pharmacy Analytics Advisor

• Provide front line staff guidance
• Ensure effective and efficient delivery of Pharmacy call center services
• Respond to physician and pharmacy network provider inquiries
• Review member claims history
• Educate and assist pharmacy network providers

Pharmacy Coordinator

• Manage pharmacy contracts including contract development, negotiation, renewal, termination, execution and hard copy/electronic storage with minimal supervision/direction.
• Collaborate directly with internal, external, and vendor legal counsel teams during the contract negotiation process, up to and including the point of contract execution.
• Interface with the Organization’s stakeholders in the management of the pharmacy and vendor contract portfolio in order to maximize value and mitigate risk to the organization.
• Partner directly with the Pharmacy Services leadership team on contracting initiatives related to specific team business needs in support of the overall organization’s strategic pharmacy contracting portfolio.
• Provide guidance or expertise to other analysts and stakeholders within the Pharmacy Services organization during collaborative initiatives.
• Addresses, investigates and resolves pharmacy contract matters / issues, post contract execution.

Pharmacy Contract Consultant

• Submit and manage prior authorization requests for medications only, as required by insurance carriers.
• Review physician medication orders, supporting clinical notes, and documentation to ensure prior authorization requests are complete and accurate.
• Track medication prior authorizations from submission through approval, denial, or request for additional information.
• Follow up with payers to ensure timely determinations and minimize delays in medication access.
• Coordinate prescription refills in collaboration with providers and pharmacies.
• Serve as the primary point of contact for pharmacies regarding medication-related questions, clarifications, and insurance requirements.
• Support enrollment and coordination of patient assistance programs for medications when applicable.
• Communicate with patients regarding medication-specific authorization requirements, timelines, approvals, denials, and next steps.
• Identify medication prior authorization denials and coordinate appeals when appropriate.
• Manage assigned work queues, tasks, and follow-ups to meet defined turnaround times.
• Maintain compliance with payer requirements, HIPAA, and organizational policies.

PSC, Medication Prior Authorization, Pharmacy

• 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

• 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

Pharmacist jobs in North Carolina

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Payor Contract Manager – Infusion

Pharmacy Technician I – Discharge Medication Pharmacy

Pharmacy Technician

Supervisor, Specialty Pharmacy Services

Clinical Pharmacist

Clinical Pharmacist, Pharmacy Outreach

Prior Authorization Systems Pharmacist

Clinical Pharmacist – Virtual Pharmacy Services

Dispensing Pharmacist, Long Term Care – Part Time

Pharmacy Technician

Pharmacy Technician

Senior Pharmacy Analytics Advisor

Pharmacy Coordinator

Pharmacy Contract Consultant

PSC, Medication Prior Authorization, Pharmacy

Clinical Pharmacist

Senior Pharmacy Performance Specialist

Clinical Pharmacist

Pharmacy Care Technician

Clinical Pharmacist, Virtual Pharmacy Services