Pharmacist

• Compound prescriptions with precision and care, strictly adhering to USP <797> and other relevant regulatory standards
• Verify the accuracy of prescriptions and ensure timely and accurate medication verification and distribution
• Collaborate with pharmacy technicians to manage medication orders, records, and the sterile compounding workflow
• Oversee and replenish medication supplies, managing inventory related to sterile products
• Engage in research activities to improve compounding techniques, develop new formulations, or investigate emerging therapies

Sterile Pharmacist – Morning Shift

• 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

• Act as the specialty pharmacy resource for your assigned clinical team(s)
• Interpret pharmacy data reporting shared by the benefit administrators
• Participate in discussions with the benefit administrators’ clinical teams
• Work to create summary reports to Mercer H&B teams
• Participate in Pharmacy Practice meetings
• Incorporate compliance and professional standards into all work processes
• Monitor success of projects in terms of client satisfaction
• Establish effective carrier/vendor relationships
• Provide mentoring and coaching to team members
• Assist in the development of ongoing training presentations
• Support wellness consulting projects by providing pharmacy expertise
• Advance clinical program effectiveness by conducting pharmacy assessments
• Assist with other consulting projects as needed

Clinical Pharmacy Consultant

• Act as the lead strategic pharmacy advisor for a group of select mid-market and national accounts, managing overall service delivery, strategy, financial evaluations, plan design review, contract renewal, business placement, and benchmarking.
• Identify current provider performance gaps and make recommendations to control spend and trend.
• Upsell Mercer pharmacy solutions.
• Leverage Mercer’s size and reputation to negotiate highly competitive Pharmacy Benefit Management (PBM) contracts.
• Lead successful regional and national marketing pursuits.
• Delegate effectively to provide developmental opportunities to team members.
• Provide mentoring and coaching to project team members.
• Manage day-to-day account/project management for key MercerRx clients.
• Thrive and be motivated by an environment that embraces AI and technology-enabled tools.

Senior Pharmacist, Benefits Consultant

• Lead efforts to improve HEDIS medication adherence and other pharmacy quality measures.
• Analyze medication adherence data, identify gaps in care, and implement targeted interventions to improve adherence rates.
• Collaborate with healthcare providers, care managers, and other stakeholders to develop and implement strategies that promote adherence to prescribed therapies.
• Conduct medication therapy management (MTM) sessions to address barriers to adherence, provide patient education, and ensure understanding of medication regimens.
• Work directly with patients to identify and resolve issues related to medication adherence.
• Utilize motivational interviewing techniques to encourage patients to adhere to their prescribed medication regimens.
• Monitor and track HEDIS performance metrics, generating reports to assess the effectiveness of interventions and programs.
• Use electronic health records (EHR) and pharmacy data to identify patients at risk of non-adherence and develop action plans.
• Serve as a medication adherence subject matter expert (SME) within the organization.

Clinical Pharmacist – HEDIS Medication Adherence

• Direct, coach, and develop team members through regular 1:1 meetings.
• Complete performance reviews, coaching documentation, and corrective actions.
• Manage staffing, schedules, queue performance, and workload balancing.
• Review KPIs including Quality, AHT, Productivity, Attendance, and SLA.
• Identify training opportunities and partner with Learning & Development.
• Handle escalated member, provider, and client concerns.
• Monitor daily operational performance against SLA, productivity, quality, and schedule adherence goals.
• Ensure compliance with HIPAA, CMS, state board of pharmacy requirements, and internal policies.
• Use reporting to identify trends and recommend corrective actions.
• Partner with Workforce Management, Training, Operations, and Leadership.
• Support continuous improvement initiatives and standardization efforts.
• Maintain documentation and confidentiality standards.
• Participate in calibration sessions and business meetings.

Participant Services Pharmacist Supervisor

• Create and Maintain Clinical Criteria for applicable Utilization Management (UM) programs: Develop and maintain clinical criteria (access to Prime standard and BCBSNE specific versions); Develop and maintain criteria process flows; Develop and maintain physician fax forms and other modes of communication; Utilize predictive modeling tool to intervene with high-risk members for identified disease states; Provide clinical updates as necessary to internal staff and physician reviewers; Performs highly complex research, analysis and develops recommendations for UM programs & plan design changes.
• Responsible for Operational workflows and Completion of UM reviews: Clinical oversight of first level review process; Clinical review of utilization management reviews; Perform clinical support for Pharmacy Technician and other staff; Utilize reporting tools to create efficiencies by reviewing medical and pharmacy claims data; Support physician reviewers with information required to efficiently review non-approvable claims; Develop Decision Tree review process when applicable.
• Maintain URAC accreditation: Work with internal staff to ensure that URAC accreditation is maintained; The pharmacist will work within their scope of licensure and unless expressly allowed by state or federal law or regulation, are located in a state or territory of the United States when conducting drug utilization review. The clinical pharmacists may not conduct peer clinical review non-certifications for drug utilization management, if prohibited by state utilization management laws. The clinical pharmacists may not conduct peer clinical review non-certifications for drug utilization management if the requesting party specifically requests a clinical peer.
• Measure quality assurance reporting, turnaround time for urgent and non-urgent reviews and quantitative assessment of UM reviews by program.
• Support Medicare Advantage processes, outreach, presentations, and tasks that require clinical direction and support. This includes, but not limited to, clinical presentations to internal and external stakeholders, providers, provider offices, and other customers.

Clinical Pharmacist

• Audit prior authorization activities
• Identify opportunities for process improvement
• Support clinical training initiatives
• Help maintain the integrity of critical pharmacy systems and data
• Partner with business groups to identify and resolve errors in data and reporting
• Assist with the administration of audit processes and tools related to prior authorizations, appeals, quality improvement, star measurement reviews, inter-rater reliability and data entry
• Assess training needs and identify, select or develop appropriate training programs including training aids and materials
• Assist with training staff in the use of audit tools and identification of patterns or trends that require additional training or corrective action
• Maintain records of training activities and employee progress
• Participate in Quality and Advisory committees or provider education meetings

Clinical Audit Coordinator, Pharmacy

• Support the team with projects related to Pharmacy strategy development, planning, and implementation
• Help drive growth, improve the affordability of products and services, and react to shifting competitive trends and external forces in the Pharmacy space

Pharmacy Strategy Consultant

• 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

• Performing Activities Associated With Administration And Management Of Pharmacy Programs Including But Not Limited To Assisting In The Development, Implementation And Maintenance Of A Disease State Formulary System.
• Utilization Management Programs.
• Specialty Pharmacy Management.
• Medication Therapy Management, Client Relationships And Support; And Development Of Innovative Clinical Programs.

Clinical Account Consultant, Pharmacy

• Lead, coach, mentor, and develop a team of Pharmacy Executives to ensure consistent delivery of exceptional client experiences and achievement of organizational objectives.
• Develop and execute the strategic vision for the Pharmacy Commit programs, ensuring alignment with Vizient's pharmacy and enterprise objectives.
• Work with leadership and client management regarding any key account and renewal of key accounts their team manages.
• Establish and monitor KPIs related to client satisfaction, contract activation, utilization, retention, and financial performance.
• Serve as executive sponsor for key Pharmacy Commit members, supporting executive business reviews, renewals, escalations, and strategic planning.
• Identify opportunities to expand participation, increase contract utilization, develop new offerings, and improve overall member value.
• Accountable for achieving revenue, savings, participation, and growth goals.
• Monitor program financial performance and recommend strategies to improve value delivered to members and Vizient.
• Standardize operational processes, establish best practices, and lead continuous improvement initiatives across the Pharmacy Commit organization.
• Identify emerging pharmacy trends, market opportunities, and innovative service offerings that enhance member value and strengthen Vizient's market leadership.
• Lead cross-functional collaboration across Pharmacy Sourcing, Consulting, Contracting, Analytics, Legal, Operations, Client Management, and Sales to deliver integrated pharmacy solutions.
• Drive contract performance by improving activation, utilization, compliance, and member adoption of pharmacy solutions.
• Provide executive oversight for Statements of Work, participation agreements, renewals, and contractual relationships to ensure alignment with strategic business objectives.
• Provide ongoing coaching and developmental support to the pharmacy teams.
• Establish and maintain a best-in-class client experience through proactive engagement, executive partnership, issue resolution, and measurable value delivery.

Senior Director, Pharmacy Commit

• Provide leadership and strategic direction to the Pharmacy Commit member facilities, distribution partners, and suppliers in collaboration with Vizient leadership and staff.
• Lead value-based initiatives, performance improvement, and revenue enhancement programs.
• Leverage clinical expertise, contracting strategies, and data-driven insights to deliver measurable value while cultivating strong member and partner relationships.
• Demonstrate a collaborative, team-based approach and take accountability for advancing pharmacy program success across highly engaged health systems.
• Manage new opportunities across contracting, policy, and analytics services.
• Drive contract performance by improving activation, utilization, compliance, and member adoption of pharmacy solutions.
• Build and maintain relationships with stakeholders up to the VP level to align strategic and operational priorities.
• Establish and monitor KPIs related to client satisfaction, contract activation, utilization, retention, and financial performance.
• Serve key Pharmacy Commit members, supporting executive business reviews, renewals, escalations, and strategic planning.
• Conduct voice-of-customer sessions to gather insights and refine program offerings.
• Oversee cross-functional project execution to deliver value-driven contracts and market insights.
• Enhance tools and processes to improve contract visibility and utilization.
• Analyze stakeholder data to identify growth opportunities and deliver actionable insights.
• Forecast revenue, pursue organic growth opportunities, and support business development efforts.
• Develop and deliver training, presentations, and customized business reviews for stakeholders.
• Diagnose healthcare challenges and recommend scalable, innovative solutions.

Pharmacy Executive IV

• Provide strategic leadership to a team of pharmacy executives, ensuring the success and impact of Vizient’s pharmacy programs.
• Drive client engagement, satisfaction, and value delivery while fostering innovation, collaboration, and strong partnerships.
• Ensure alignment of pharmacy initiatives with organizational goals, key performance indicators (KPIs), and client value propositions to achieve measurable outcomes.
• Lead pharmacy executives to deliver exceptional client satisfaction and program success.
• Serve as a national pharmacy leader and primary account contact, driving engagement, renewals, growth opportunities, and issue resolution.
• Create partnership with Chief Pharmacy Officers (CPOs) to strengthen executive relationships and align on goals.
• Deliver client financial objectives through contract and Novaplus compliance, cost savings, revenue maximization, cost avoidance, rebate optimization, and reserve program value.
• Achieve targets for pharmacy program revenue, client value delivery, renewals, and new business opportunities.
• Guide execution of pharmacy spend management strategies to enhance access, commitment, and resource stewardship.
• Drive financial sustainability and growth across all pharmacy category programs.
• Provide thought leadership to advance program initiatives and maximize member value.
• Develop, coach, and mentor pharmacy executives to strengthen leadership, execution, and client impact.
• Recruit, evaluate, and retain talent to enhance engagement, succession planning, and business continuity.
• Partner with internal teams to ensure seamless implementations and achievement of savings guarantees.
• Contribute to pharmacy pricing strategies for RFPs, new business development, and deal models, including narrative development for proposals and presentations.
• Collaborate with sales, solution architects, spend leaders and pharmacy leaders to support cross-selling, upselling, and client success.
• Foster collaboration across internal stakeholders and provide constructive feedback to program owners.

VP, Pharmacy Spend Management Delivery

• Aggregate and analyze data to produce detailed reports
• Develop and implement performance measures for pharmacy network contracts
• Identify and flag potential fraud, waste, and abuse within the pharmacy network
• Collaborate with cross-functional teams across the enterprise to support strategic decision-making
• Manage relationships with internal stakeholders to ensure alignment and effective communication
• Support the Director of Network Pharmacy in monitoring pharmacy performance
• Assist in budget planning and financial performance analysis of the pharmacy network
• Contribute to quality improvement initiatives to enhance service delivery
• Ensure compliance with federal, state, and local regulations

Pharmacy Network Manager

• 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

• Collaborates with the technicians and prior authorization team members to process referrals
• Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design
• Guarantee that decisions regarding cases are conveyed promptly and efficiently
• Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients
• Establishes and maintains communication among CVS Caremark, health plan, and employer group staff
• Maintains professional and technical knowledge of drug and disease states
• Performs other related projects and duties as assigned

Clinical Pharmacist – Prior Authorization

• Responsible for driving growth in Specialty by building innovative products
• Develop robust product roadmap based on current and anticipated market trends
• Collaborate across the organization to deliver new solutions to market
• Build and execute product roadmap that solves payor, provider and patient needs
• Leverage pharmacist expertise to inform clinical strategy and performance
• Assist in the development of tools and processes to improve effectiveness
• Collaborate with external partners to develop strategies for managing high-cost medical drugs

Senior Manager – Oncology & Rare Disease Products

• Compound prescriptions with precision and care, strictly adhering to USP <797> and other relevant regulatory standards
• Verify the accuracy of prescriptions and ensure timely and accurate medication verification and distributions
• Collaborate with pharmacy technicians to manage medication orders, records, and the sterile compounding workflow
• Oversee and replenish medication supplies, managing inventory related to sterile products
• Engage in research activities to improve compounding techniques, develop new formulations, or investigate emerging therapies

PRN Sterile Compounding Pharmacist, Part Time, Morning Shift

• Utilize your pharmacy knowledge to assist with medication-related inquiries
• Support prescription processing activities
• Provide exceptional customer service to patients
• Join a team dedicated to improving healthcare experiences while helping individuals navigate their pharmacy and medication needs with confidence

Pharmacist jobs in Texas

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