Pharmacist

• Support the pharmacy team in delivering operational and service excellence within the store
• Assist patients and customers as the first point of contact
• Ensure pharmacy operations run smoothly and prescriptions are filled accurately
• Follow Standard Operating Procedures (SOPs) and best practices
• Complete company training program and satisfy registration, licensing, and certification requirements as per Board of Pharmacy guidelines

Pharmacy Technician

• Provide pharmacist care by collaborating with multidisciplinary healthcare teams
• Promote guidelines and policies to improve care for patients
• Ensure patient compliance and minimize risk associated with high risk medications
• Collect data and submit as required by various pay-for-performance initiatives

Pharmacy Quality Specialist

• 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

• Support the pharmacy team in delivering operational and service excellence within your store
• Assist the pharmacy team to ensure that pharmacy operations run smoothly, our patients’ prescriptions are filled promptly, safely, and accurately
• Show empathy and genuine care, creating heartfelt and personalized moments while serving patients
• Complete basic inventory activities, such as 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, and voluntarily staffing offsite clinics)

• Review medication lists to eliminate barriers to therapy
• Contact pharmacies for medication refills
• Document care and communicate with providers
• Facilitate access to medications for financially challenged members

Clinical Pharmacy Technician

• Manage real time insurance claims while providing customer service to clients
• Analyze and approve claims that need to be adjudicated
• Determine coverage and apply medical necessity guidelines
• Identify and clarify any discrepancies to complete the adjudication process
• Work in cohesion with the CIC Department, Prior Authorization, and Billing Departments
• Submit claims and add appropriate corrections
• Ensure accurate and timely processing of real time claims
• Work directly with third party payers for claim resolution
• Communicate with facilities on claim issues that will need attention by the facility
• Resolve any discrepancies and secure proper reimbursement
• Any other duties associated with adjudication
• Create Prior Authorizations and notify Authorization team
• Follow federal and state regulations
• Adhere to company policies and procedures
• Follow HIPPA guidelines and regulations

Pharmacy Adjudication Specialist

• 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

Pharmacist jobs in West Virginia

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Pharmacy Technician

Pharmacy Quality Specialist

Senior Pharmacy Performance Specialist

Pharmacy Technician

Clinical Pharmacy Technician

Pharmacy Adjudication Specialist

Clinical Pharmacist – Medicare STARS