UNKNOWN

ADAPTED_NOW

HOUR

Candidate Requirements Education/Certification Required: B.S. in Pharmacy or PharmD Preferred: Licensure Required: required to be licensed in state of residence Preferred: Years of experience required: at least 2 years MTM experience. Develop clinical criteria for medications, recommend plan design changes, and initiate clinical programs.

Axelon

Clinical Pharmacist

Assist case management team with members including clinical rounds presentations Purpose: Primary duty for this position is to review prior authorization requests for medical benefit (buy and bill) drugs requests across the Medicare, Medicaid, Exchange, and Commercial lines of business. Disqualifiers: Additional qualities to look for: Preferred experience with outlook, teams, SharePoint, excel.

Clinical Pharmacist 1 - 210392

Conduct outbound outreach to members, providers, and pharmacies to support pharmacy quality initiatives focused on medication adherence, high-risk medication use, and appropriate therapy measures. Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns.

Pharmacy Coordinator

Online studies typically take 15 minutes, while telephone interviews may take 30-60 minutes each session. Some studies such as clinical trial in-person focus groups pay as high as $500 per study.

WEEK

Product Review Jobs

Paid Product Tester

Capital Markets Placement_feed

Physicians set their own visit schedule within a structured weekly framework, work from anywhere, and practice without the administrative overhead of a traditional office, supported by a streamlined EMR and a dedicated provider-support team. Since our founding in 2019, we've helped more than 100,000 patients access essential medical treatment, with a primary focus on addiction care, and growing programs in weight management and general telehealth services.

YEAR

QuickMD

Remote Physician

One Red Cent - Marketplace

FEED

The case mix is approximately half cross-sectional studies and half plain films, with an estimated 70–80 RVUs per shift. The Remote Radiologist should be looking for a unique opportunity to improve their practitioner skills, grow their business acumen and learn alongside the founder.

<h4>Overview</h4>
<p>K.A. Recruiting is a Healthcare Recruiting company that was established in order to serve the growing need for allied healthcare professionals, doctors, nurses, nurse practitioners, pharmacists, physician assistants and physical therapists. We help to find top notch candidates for hospitals, reference labs, long-term care facilities, home health agencies, rehabilitation centers, non profit organizations, etc. CHECK OUT OUR CURRENT JOB OPPORTUNITIES: JOBS.KA-RECRUITING.COM Like us on Facebook: https://www.facebook.com/pages/KA-Recruiting-Inc/210685185178</p>
<dl>
<dt>Website</dt>
<dd><a href="http://www.ka-recruiting.com/" target="_blank" rel="noopener noreferrer"><span dir="ltr">http://www.ka-recruiting.com</span></a></dd>
<dt>Industry</dt>
<dd>Staffing and Recruiting</dd>
</dl>

K.A. Recruiting

Radiologist (REMOTE - WORK FROM HOME)

HaleyMarketing

The role works closely with manufacturers and internal sales teams to ensure seamless account management and exceptional customer satisfaction, while building long-term relationships that support sustained business success and market growth. This Outside Sales Manager role offers the opportunity to drive revenue growth by identifying product expansion opportunities, delivering impactful product training, and developing commercial solutions that strengthen customer partnerships and increase sales performance.

Naviga Recruiting & Executive Search

Outside Sales Manager (Remote)

OTHER

https://jobs.micro1.ai/post/31dc936e-0f29-441f-baf9-91c2ff9cc7d4?referralCode=dee54f31-3aa4-4464-a2c3-669810631e84&utm_source=referral&utm_medium=share&utm_campaign=job_referral . If possible, try taking the interview at a different time of day, as internet performance can vary depending on network traffic.

Pro Integrate

Mobile Developer | Remote contract role.

Ceipal

Reason for the Request: The additional Nurse Case Manager is needed to support the team s increasing workload, allowing regular staff, including leaders and subject matter experts, to focus on essential strategic initiatives such as UAT, policy rewrites, and preparation for the new platform launch. Purpose of This Team: To provide comprehensive care coordination for home infusion patients, ensuring optimal outcomes through clinical data management, effective communication with providers, and adherence to best practices.

Pacer Group

Care Manager (RN)

Employee will conduct outbound outreach to members, providers, and pharmacies to support pharmacy quality initiatives focused on medication adherence, high-risk medication use, and appropriate therapy measures. Additional qualities to look for: Medicare/Quality experience preferred, Advanced Microsoft office experience preferred (Excel, Word, Teams, Outlook), Customer service .

Clinical - Pharmacy Coordinator 1 - 210120

Candidate Requirements Required: High school diploma or equivalent Preferred: Required: Preferred: Years of experience required: Minimum of 2 years of experience in Grievance and Appeals operations within a healthcare or managed care environment, with a strong understanding of appeals, case processing, regulatory requirements, and applicable turnaround times. The role requires extensive investigation across multiple systems, coordination with Clinical, Claims, Utilization Management, providers, and leadership, and the ability to manage complex, high-priority cases with significant regulatory and operational impact.

Mindlance

BusinessOperations - Grievance & Appeals Coordinator I - 210056

jobdiva

Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to members. Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care.

Clinical - Clinical Review Nurse - Prior Authorization - J00927

The role includes member outreach, completing assessments, identifying Care Management needs, documenting activities in TruCare, managing referrals, supporting resource navigation, and collaborating with internal teams to address member needs. required" "Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate.

BusinessOperations - Care Coordinator II - J01000

2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience. " Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated.

Clinical - Clinical Pharmacist 1 - 210392

1 Utilization Management or Appeals review background (1 plus year) 2 Medicare NCD/LCD and InterQual/Milliman Software (1 plus year) 3 Retrospective claims clinical reviews (1 plus year) Candidate Review & Selection Shortlisting process. Required: RN, LPN Preferred: LVN Must haves: Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization Management or Appeals.

Clinical - Clinical Review Clinician - Appeals - J00923

Candidate Requirements Education/Certification Required: High school diploma or equivalent Preferred: Licensure Required: Preferred: Years of experience required: Minimum of 2 years of experience in Grievance and Appeals operations within a healthcare or managed care environment, with a strong understanding of appeal intake, case processing, regulatory requirements, and applicable turnaround times. The team is responsible for monitoring and processing incoming emails and faxes, triaging Member and Provider Workbasket queues, identifying the appropriate case classification, and ensuring submissions are accurately documented and routed to the correct processing teams.

BusinessOperations - Intake Representative I - 700236

Candidate Requirements Education/Certification Required: High School Diploma or GED Preferred: Licensure Required: Pharmacy Technician License Preferred: Years of experience required: 3+ years of retail, hospital or mail order pharmacy experience. Loan Nguyen (PTO 10/12 10/13) Compliance Questions (Department of Defense) Will this role operate, support, or utilize DOD data, systems, and/or infrastructure, requiring a National Agency Check with Law and Credit Checks (NACLC)?

Clinical - Exception Template

Additional qualities to look for: Medicare/Quality experience preferred, Advanced Microsoft office experience preferred (Excel, Word, Teams, Outlook), Customer service Top 3 must-have hard skills stack-ranked by importance. Employee will conduct outbound outreach to members, providers, and pharmacies to support pharmacy quality initiatives focused on medication adherence, high-risk medication use, and appropriate therapy measures.

Position Purpose: The Pharmacy Technician may perform duties in one or more of the following areas: Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part D Operations and State Health Programs Pharmacy Operations or Prior Authorization. Prior Authorization: " Reviews requests made by physicians and pharmacies for use of prescription drugs that are non-formulary, have prior authorization requirements, have exceeded quantity or cost limits, or require assistance in on-line processing of a prescription claim.

Clinical - Pharmacy Technician 1 - 700357

You will complete a short screening form so our system can match you with relevant consumer research opportunities within our national insights program. All tasks are conducted online and can be completed outside traditional business hours.

Work From Home Jobs in Sebring, FL

Clinical Pharmacist Axelon

Clinical Pharmacist 1 - 210392 Axelon

Pharmacy Coordinator Axelon

Paid Product Tester Product Review Jobs

Remote Physician QuickMD

Radiologist (REMOTE - WORK FROM HOME) K.A. Recruiting

Outside Sales Manager (Remote) Naviga Recruiting & Executive Search

Mobile Developer | Remote contract role. Pro Integrate

Care Manager (RN) Pacer Group

Clinical - Pharmacy Coordinator 1 - 210120 Pacer Group

BusinessOperations - Grievance & Appeals Coordinator I - 210056 Mindlance

Clinical - Clinical Review Nurse - Prior Authorization - J00927 Mindlance

BusinessOperations - Care Coordinator II - J01000 Mindlance

Clinical - Clinical Pharmacist 1 - 210392 Mindlance

Clinical - Clinical Review Clinician - Appeals - J00923 Mindlance

BusinessOperations - Intake Representative I - 700236 Mindlance

Clinical - Exception Template Mindlance

Clinical - Pharmacy Coordinator 1 - 210120 Mindlance

Clinical - Pharmacy Technician 1 - 700357 Mindlance

Remote Research Participant No Experience Required Occupons Quebec

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