Utilization Management Pharmacist Jobs in Los Angeles, CA

Drive patient access and reimbursement strategies in a dynamic environment. Collaborate with healthcare providers and pharmacies to ensure timely treatment initiation while navigating complex authoriz...

Shape the future of patient care by leading utilization review processes, ensuring effective discharge planning, and collaborating with multidisciplinary teams to enhance patient outcomes and resource...

Join a team that's dedicated to delivering exceptional client service and operational excellence. As a Program Manager, you'll oversee program execution, account management, and financial oversight wh...

Lead a team in Medical Informatics to drive analytics for Utilization Management. Translate clinical priorities into actionable strategies, enhance performance insights, and support operational improv...

Transform healthcare analytics by leading a team to enhance utilization management strategies, drive operational improvements, and deliver actionable insights that optimize member outcomes and afforda...

Lead the charge in enhancing clinical systems operations, driving efficiency and effectiveness across pharmacy initiatives while managing a dedicated team and overseeing complex workflows and data int...

Lead the charge in enhancing claim payment accuracy by driving cross-functional initiatives, leveraging analytics, and implementing sustainable solutions to reduce payment leakage and improve operatio...

Elevate operational excellence by leading claims operations, ensuring compliance and efficiency while driving process improvements and team development. Collaborate across functions to meet client com...

Reimagine health plan payment integrity by leading operational projects, analyzing claims data, and collaborating across teams to enhance compliance and financial outcomes. Drive strategic initiatives...

Lead the charge in managing laboratory operations, ensuring quality and compliance while overseeing testing processes. Collaborate with medical staff and administration to enhance efficiency and meet...

Champion data-driven insights as you lead a multidisciplinary analytics team, driving client performance and strategic recommendations to enhance business growth and market competitiveness...

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...

Lead the charge in managing Medicare Stars programs, ensuring compliance and quality improvement through strategic project management and interdepartmental collaboration. Drive initiatives that enhanc...

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...

Transform Medicare Stars operations by leading cross-departmental projects, ensuring compliance and quality improvement. Collaborate with leadership to drive strategic initiatives and manage program i...

Accelerate progress at the forefront of healthcare operations, leading teams to enhance patient access and operational efficiency. Drive initiatives in a dynamic environment, fostering collaboration a...

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...

Join a dynamic team as you assist licensed pharmacists in dispensing medications, managing insurance claims, and ensuring compliance with healthcare regulations while gaining valuable hands-on experie...

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...