Remote Clinical Utilization Pharmacist UM Expert

Job Opportunity At 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 and disease management...

Company DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an...

Company DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization...

Join Our Caring CommunityBecome a part of our caring community and help us put health first. The UM Administration Coordinator provides clerical support for the department. We are the beginning, middle, and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses, and with other team members. Achieve your...

Join to apply for the Sr Medical Director – Utilization Management role at Wellmark Blue Cross and Blue Shield 5 days ago Be among the first 25 applicants Join to apply for the Sr Medical Director – Utilization Management role at Wellmark Blue Cross and Blue Shield Why Wellmark We are a mutual insurance company owned by our policy holders across Iowa and...

UM Administration Coordinator 2Become a part of our caring community and help us put health first. The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations....

Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or...

Job DescriptionAbout the Opportunity: As an experienced M.D. or D.O. in adult acute care setting(s), you will use evidence-based decision making to perform inpatient case reviews that are timely and clinically appropriate. You will concisely, effectively, and consistently synthesize clinical information to document a clear summary of a medically necessary...

Job DescriptionAbout the Opportunity: As an experienced M.D. or D.O. in adult acute care setting(s), you will use evidence-based decision making to perform inpatient case reviews that are timely and clinically appropriate. You will concisely, effectively, and consistently synthesize clinical information to document a clear summary of a medically necessary...

Company DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization...