4 senior pharmacist jobs found

Become a part of our caring community and help us put health first The Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend and improve health outcomes. The Director, Clinical Pharmacy requires an in-depth understanding of how organization capabilities interrelate across the function or segment. Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana enterprise, HPS executive leaders as well as engagements with external vendors. Job Description The Director, HPS Clinical Programs requires a broad understanding of pharmacy, managed care, and patient centered clinical programs with a focus on...

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 Paralegal Sr (LIcensing) - Remote Job Description The Paralegal Senior (Licensing) is responsible for managing one or more specified business or legal functions and is responsible for collaborating with attorneys, other paralegals, and other Prime professionals to provide complex legal support and assistance. Responsibilities Create, prepare, review, proof, edit and manage highly complex documents, including contracts, corporate records, correspondence, reports, and presentations Research and analyze highly complex issues in a wide variety of subject areas of health care law affecting Pharmacy Benefit Management (PBM) companies, customers and pharmacies; find resolution for escalated issues Negotiate...

Job Description The Health Care Executive is an integral member of a multidisciplinary team consisting of providers, nurses, and pharmacists. This role requires a unique blend of clinical expertise, leadership, informatics, change management, and data science skills. With an emphasis on referral management, the Clinical Executive will focus on enhancing patient care, improving end-user satisfaction with the Electronic Health Record (EHR) system, and achieving optimal health outcomes for patients. The team plays a pivotal role in integrating technology into healthcare practices, considering people, processes, and technology from EHR deployment to sustainment phases. Key Responsibilities: Clinical Integration : Apply institutional knowledge of policies, practices, and legacy systems to successfully integrate and sustain the EHR system, ensuring it aligns with clinical workflows and enhances patient care. Technology Advocacy : Support the development and...

Company : Highmark Inc. Job Description : JOB SUMMARY The incumbent is responsible for developing and maintaining an anti-fraud program which includes development and delivery of training and filing of Fraud Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged fraud, waste and abuse perpetrated by providers, members, facilities, pharmacies, groups and/or employees of the organizations and Subsidiaries. The incumbent is responsible for interviews which might include providers and members and may be conducted onsite or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to fraud, waste and abuse. Must be able to testify in a court of law, prepare cases for referral to various...