Utilization Management Pharmacist Jobs in Pittsburgh, PA

Shape the future of patient care by leading a dynamic team in a fast-paced clinic. Drive operational excellence, enhance patient experiences, and support staff development in a nationally recognized a...

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...

Partner with us to lead nursing excellence in a dynamic invasive cardiology unit. Drive patient care quality, mentor staff, and enhance clinical practices while fostering a collaborative environment i...

Lead the coordination of compassionate hospice care by assessing patients, collaborating with care teams, and developing tailored care plans that address individual needs and enhance quality of life f...

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...

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...

Lead the charge in optimizing commercial pharmacy logistics through project management, automation, and continuous improvement initiatives. Collaborate with cross-functional teams to enhance operation...

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...

Contribute to patient care by delivering specialized pharmacy services, collaborating with healthcare teams, and ensuring optimal medication management for outpatients. Engage in quality programs to e...

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...

Optimize pharmaceutical services by compounding and dispensing medications, ensuring compliance with state regulations while collaborating with healthcare teams to enhance patient care and departmenta...

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...