Pharmacist - Case and Disease Management (CMDM) - Remote
4 weeks ago
Pharmacist Company: Highmark Inc. Job Summary: This job works as part of a product-line specific (MA, ACA, Commercial) multi-disciplinary team to close gaps in care for high-risk members. Through the multi-disciplinary team, patients who have high risk gaps in care related to medication therapy are transitioned to a Pharmacist for Case & Disease Management (CMDM). The incumbent then conducts thorough research to evaluate the patient and extensive clinical judgement and discretion to provide recommendations for closing the gap in care. The incumbent may interact with the patient or care giver, physician, and/or pharmacist through the intervention. Essential Responsibilities: Review gaps in care for high risk patients as part of a multi-disciplinary team. Conduct research including gathering claims data, reviewing clinical websites, etc. to thoroughly evaluate each patient's unique situation to provide the appropriate clinical recommendation. Contact patients, care givers, physicians, pharmacists, etc. to intervene on identified gaps of care using a high level of clinical judgement and discretion. Other duties as assigned. Education: Required: Bachelor's Degree in Pharmacy Substitutions: None Preferred: Doctorate in Pharmacy Experience: Required: Required experience can be reduced from 3-5 to 1-2 years if the candidate completed a clinical residency program. 5 - 7 years in Pharmacy + 3 - 5 years in Pharmacist - Utilization Management + 3 - 5 years in Pharmacist - Medical Therapy Management Preferred: None Licenses and Certifications: Required: Registered Pharmacist Preferred: None Skills: Oral & Written Communication Skills Telephone Skills Problem Solving & Decision Making Compliance Collaborative Problem Solving Language (Other than English): None Travel Requirement: 0% - 25% Physical, Mental Demands and Working Conditions: Position Type: Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. Pay Range Minimum: $78,900.00 Pay Range Maximum: $147,500.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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Carson City, United States Remote Staffing Full timePharmacist Company: Highmark Inc. Job Summary: This job works as part of a product-line specific (MA, ACA, Commercial) multi-disciplinary team to close gaps in care for high-risk members. Through the multi-disciplinary team, patients who have high risk gaps in care related to medication therapy are transitioned to a Pharmacist for Case & Disease Management...
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Oklahoma City, United States Remote Staffing Full timePharmacist Position Company: Highmark Inc. Job Summary: This job works as part of a product-line specific (MA, ACA, Commercial) multi-disciplinary team to close gaps in care for high-risk members. Through the multi-disciplinary team, patients who have high risk gaps in care related to medication therapy are transitioned to a Pharmacist for Case & Disease...
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Carson City, United States Humana Full timeA healthcare company seeks a Staff Utilization Management Pharmacist to evaluate complex clinical scenarios and conduct medication reviews. This remote position involves critical thinking and clinical guidance focused on cost-effective medication use. The ideal candidate must hold a Pharm.D. and an active pharmacist license. Benefits include a hiring bonus,...
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Carson City, NV, United States Humana Full timeA healthcare company seeks a Staff Utilization Management Pharmacist to evaluate complex clinical scenarios and conduct medication reviews. This remote position involves critical thinking and clinical guidance focused on cost-effective medication use. The ideal candidate must hold a Pharm.D. and an active pharmacist license. Benefits include a hiring bonus,...
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Remote Pharmacist: Clinical Operations Advisor
3 weeks ago
Carson City, United States CVS Health Full timeA leading healthcare company is seeking a Clinical Operations Advisor to collaborate with clients on clinical strategies and operational plans. This remote position requires an active pharmacist license and experience in managed care. Responsibilities include designing clinical setups and ensuring compliance with regulations. Exceptional communication and...
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Senior Clinical Programs Pharmacist
1 week ago
Carson City, United States Humana Full timeA leading healthcare provider in the United States is seeking a Senior RX Clinical Programs Pharmacist to oversee medication therapy and optimize prescription drug use. The role involves engaging with patients, overseeing medication reviews, and influencing department strategy. Candidates should hold a PharmD or similar, be licensed as a pharmacist, and...
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Carson City, United States Remote Staffing Full timeDatavant Coding SupervisorDatavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable...
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Remote-Pharmacist
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Scrum Master
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Carson City, United States Remote Staffing Full timeJoin SitusAMC SitusAMC is where the best and most passionate people come to transform our client's businesses and their own careers. Whether you're a real estate veteran, a passionate technologist, or looking to get your start, we proudly serve. At SitusAMC, we are looking to match your unique experience with one of our amazing careers, so that we can help...
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Scrum Master
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Carson City, United States Remote Staffing Full timeJoin SitusAMC SitusAMC is where the best and most passionate people come to transform our client's businesses and their own careers. Whether you're a real estate veteran, a passionate technologist, or looking to get your start, we proudly serve. At SitusAMC, we are looking to match your unique experience with one of our amazing careers, so that we can help...
