Utilization Management Pharmacist Jobs in Buffalo, NY

Join a dynamic team to develop and manage supply chain contracting strategies that optimize costs and enhance value for member pharmacies. This role involves supplier negotiations, category performanc...

Manage and lead field-based medical teams, ensuring client delivery and team performance while fostering scientific engagement and program growth. Collaborate with cross-functional teams to achieve st...

Lead the charge in optimizing coding accuracy and compliance by analyzing complex patient care documentation, providing expert guidance, and enhancing coder education to ensure adherence to ethical st...

Join a team that's dedicated to conducting thorough medical reviews and applying clinical judgment to ensure compliance and prevent fraud in healthcare claims. Collaborate with professionals to suppor...

Drive the success of inpatient Payment Integrity programs by overseeing audits, ensuring compliance, and enhancing quality across teams and vendors. Collaborate with stakeholders to optimize processes...

Lead the charge in delivering exceptional pharmaceutical care by interpreting prescriptions, consulting with patients, and ensuring quality assurance. Collaborate with healthcare professionals to opti...

Lead PBM compliance audits, ensuring adherence to state regulations and industry standards. Supervise examiners, manage client relationships, and adapt to a fast-paced environment while driving progra...

Drive strategic growth by managing high-impact relationships with health systems and specialty pharmacies. Lead account management, enhance client satisfaction, and identify opportunities for value ex...

Transform pharmacy benefit strategies as a strategic consultant, leading procurement initiatives and optimizing programs for employer clients. Oversee analytics operations while delivering insights on...

Unlock financial insights at a strategic level, driving value realization and governance for transformation investments. Collaborate across functions to enhance performance, support decision-making, a...

Drive your career forward by managing reimbursement support in a dynamic environment. Engage with healthcare providers, educate on reimbursement processes, and enhance patient services while collabora...

Join a team that's dedicated to enhancing patient access by managing reimbursement challenges and providing education to healthcare providers. This role requires strong relationship-building skills an...

Unlock your potential in a dynamic pharmacy role focused on patient care and medication management while leading a team to enhance therapeutic outcomes and streamline pharmaceutical operations within...

Empower operational excellence by leading provider data governance and attribution processes. Collaborate across departments to ensure data integrity, enhance reporting accuracy, and drive continuous...

Transform your career by leading underwriting teams, driving pricing strategies, and ensuring financial performance. Collaborate across departments to influence business growth and deliver sustainable...

Join a team that's redefining care management by leading strategic initiatives in utilization and appeals processes. Drive high-quality, cost-effective care while ensuring compliance and fostering a c...

Optimize cross-portfolio analytics to enhance Gross-to-Net performance, identify anomalies, and drive process improvements. Collaborate with diverse teams to deliver actionable insights and scalable r...

Drive automation and AI initiatives in claims operations, enhancing efficiency and accuracy. Lead a team to optimize workflows, manage vendor performance, and ensure compliance while delivering measur...

Lead the charge in optimizing drug library implementations for smart infusion pumps, collaborating with healthcare teams to enhance medication safety and workflow efficiency across mid- to large-sized...

Lead NCQA Health Outcomes and Community-Focused Care Accreditation initiatives, driving quality improvement and compliance across health plans. Collaborate with teams to enhance equitable health outco...

Shape the future of healthcare reimbursement by developing and implementing payment policies that enhance accuracy, compliance, and provider experience in a dynamic payer environment. Collaborate with...

Drive statistical leadership in oncology clinical development, guiding study design, analysis, and regulatory submissions. Collaborate with cross-functional teams to ensure high-quality deliverables a...

Join a dynamic team as a Medical Claims Auditor, ensuring compliance and integrity in healthcare payments. Collaborate with cross-functional teams to identify fraud, waste, and abuse while leveraging...

Lead transformative process improvements to enhance healthcare quality and efficiency. Collaborate with teams to elevate performance metrics, oversee cultural competency initiatives, and drive strateg...

Grow your career with a dynamic team focused on optimizing provider operations. Lead credentialing initiatives, implement AI solutions, and enhance workflows while ensuring compliance and operational...