13 pharmacist jobs found in Madison

Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Earn a $5,000 hiring bonus! Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment." Location: Remote - United States Schedule: 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST Required to work every 5th Saturday Required to work 1 company holiday...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job Coordinate pharmacy services to provide safe and appropriate care in a professional manner to patients/customers of Allegheny Health Network Home Infusion. Provides clinical services to assist healthcare providers in treating patients safely and effectively in accordance to state and federal laws. ESSENTIAL RESPONSIBILITIES: Admixture and dispensing of medication and parenteral solutions to patients. Dispense pharmaceutical supplies as appropriate to patients in alternate care. Maintain quality control requirements. Accurate and timely documentation in the clinical record. Coordinate medication and supply deliveries to patients. Provide information regarding drugs and their safe and appropriate use to other healthcare providers involved in the patient's/client's care. Actively participate in ongoing interdisciplinary communication specific to...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Inc. Job Description : JOB SUMMARY This job requires the incumbent to balance clinical and business acumen to implement and provide ongoing support and oversight of assigned pharmacy programs. This pharmacist will work in a team-oriented environment as a subject matter expert of assigned pharmacy program offerings with both clinical and non-clinical focus. The incumbent is responsible for implementation, market introduction, overall performance, and continuous improvement of their assigned programs. The incumbent will work with internal partners and leadership to develop a firm grasp of the Organization's clinical program strategy as it evolves over time to enhance the value that is delivered to the Organization's customers. ESSENTIAL RESPONSIBILITIES Define the Organization's clinical product eminence strategy and plan, including the identification of key activities (e.g., conferences, publications, white papers, webinars, etc.) that will...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Pharmacy Technician II - MCP Clinical Liaison - Remote Job Description Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Responsibilities Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists. Escalates requests to Pharmacist...

Company : Highmark Inc. Job Description : JOB SUMMARY This job provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. ESSENTIAL RESPONSIBILITIES Communicate effectively with physician and pharmacy network providers to ensure that the needs of the...

Job Description We're on a journey to advance how health happens with technologies that empower patients, support clinicians, inspire innovation, and save lives. Our mission? To create a human-centric healthcare experience powered by unified global data. It's a big challenge, but big challenges are what we do best. We're already transforming some of the world's largest health systems-helping them turn data into lifesaving decisions and better patient care. We want people just as dedicated as we are to improving health equity and delivering quality care across the globe. If you're excited about making healthcare more human, you've come to the right place. We are looking for an experienced consulting professional who has an understanding of inpatient pharmacy solutions, pharmacy industry best practices, multiple business processes or technology designs within the pharmacy of a hospital. You will operate independently to provide quality work products to an engagement as...

Job Description Principal Consultant - Outpatient Pharmacy Travel: Up to 50% | Location: Remote (U.S.) At Oracle Health, we're not just building software-we're transforming how health happens. Our mission is bold yet simple: to create a smarter, more connected healthcare ecosystem where technology empowers clinicians, elevates patient care, and ultimately saves lives. As a Principal Consultant specializing in Outpatient Pharmacy, you'll be at the heart of that transformation. You'll bring your pharmacy expertise and implementation know-how to help some of the world's largest healthcare organizations design safer, faster, and more efficient pharmacy workflows. From inpatient to outpatient, your work will make a real-world difference for providers and patients alike. What You'll Do In this role, you'll lead client engagements from strategy through go-live, serving as a trusted advisor and hands-on expert. You'll: Partner with pharmacists, technicians,...

Summary This position serves as an Advanced Medical Support Assistant (MSA) in support of the Emergency Department at the William S. Middleton Memorial VA Hospital. This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Clarification from the agency All U.S. Citizens NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below. Duties VA Careers - Medical Support Assistant: https://youtube.com/embed/EE9c4XkaELo Total Rewards of a Allied Health Professional The Advanced MSA is responsible for checking in/checking out patients through the Emergency Department. Duties include but are not limited to: Scheduling the patient into the ED using VISTA and updating EDIS board for immediate provider access Daily review and management of EDIS program Identifying at ED check Veterans in need of updating personal or financial...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Provider Relations Manager - Remote Job Description The Manager of Provider Relations plays a critical leadership role in developing, managing, and maintaining strong internal and external relationships. The role is responsible for overseeing pharmacy outreach, independent pharmacy contracting, compliance and issue resolution with pharmacies to ensure network integrity, service quality, and cost-effectiveness. The role is also responsible for leading and managing a Provider Relations team to ensure effective performance management of employees, departmental interaction, and process improvements. Responsibilities Manage and mentor a team to achieve team and company goals, monitor performance and provide coaching and...

Project Coordinator Anywhere Type: Contract Category: Program/Project Management Industry: Life Sciences Workplace Type: Remote Reference ID: JN -112025-104507 Date Posted: 12/20/2025 Shortcut: http://careers.eliassen.com/WbqMlB Description Recommended Jobs Description: *100% Remote | EST hours * Our client, a leading global pharmaceutical solutions and distribution company focused on improving access to medications and healthcare products around the world. They support the full healthcare value chain by partnering with drug manufacturers, care providers, pharmacies, and other stakeholders to ensure reliable delivery, logistics, and commercialization of pharmaceuticals and related services We can facilitate w2 and corp-to-corp consultants. For our w2 consultants, we offer a great benefits package that includes Medical, Dental, and Vision benefits, 401k with company matching, and life insurance. Pay: $32 - $40/hr...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Client Concierge Specialist Sr - Remote Job Description The Senior Client Concierge Specialist is responsible for processing, communicating, documenting, and tracking more complex member cases for Pharmacy Concierge Services. This position is also responsible for interacting with members, pharmacies, prescribers, or plans to provide support and assistance with concierge program inquiries and other administrative functions. Responsibilities Set up, track, and monitor daily workflow based on client needs Analyze and trouble-shoot complex cases by researching, gathering and documenting relevant information relating to the case in both the claims processing system and case management systems within pre-determined...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Option Care Health. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Extraordinary Careers. Endless Possibilities. With the nation’s largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical...