Clinical Pharmacist/Advisor

Title: Clinical Pharmacist Advisor - Medicare - Remote Mandatory skills: managed care, PBM environment, institutional healthcare, pharmacy, Case Review, Processing, incoming coverage-related requests, Accurately set up cases, review documentation, apply work instructions, business, medical correspondence, technical procedures, Medicare regulations, Outreach, Information Gathering, Conduct outbound calls, positive business image, Documentation, Accuracy, Compliance Standards, CMS-mandated timelin

Title: Clinical Pharmacist Advisor - Remote Mandatory skills: managed care, PBM environment, institutional healthcare, pharmacy, Case Review, Processing, incoming coverage-related requests, Accurately set up cases, review documentation, apply work instructions, business, medical correspondence, technical procedures, Medicare regulations, Outreach, Information Gathering, Conduct outbound calls, positive business image, Documentation, Accuracy, Compliance Standards, CMS-mandated timelines, departm

Role: Clinical Care Advance (CCA) Configuration Analyst Experience: 5 12 Years Role Summary We are seeking experienced TriZetto Clinical Care Advance (CCA) Configuration experts to support a large-scale Utilization Management (UM) and Prior Authorization (PA) modernization program for a leading US Healthcare payer. The role involves hands-on configuration of CCA workflows, business rules, authorizations, correspondence, and integrations. Key Responsibilities Configure CCA workflows and busine

We are seeking to hire several Project Managers with expertise in Medicare/Medicaid system implementation projects, including specific expertise in PBM (Pharmacy Benefits Management), to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of health