Utilization Management Pharmacist Jobs in San Diego, CA

Lead the charge in managing a clinical review team to ensure optimal member care through effective utilization management and compliance with healthcare standards. Drive improvements and foster commun...

Lead a dynamic team in enhancing member-centered care through effective utilization management. Drive quality improvement, ensure compliance, and foster strategic partnerships to optimize healthcare d...

Lead the charge in optimizing utilization management operations, enhancing efficiency, and driving performance improvements. Collaborate with clinical and operational teams to ensure timely reviews an...

Transform your career by overseeing utilization management operations, leading a dedicated team, and ensuring compliance within a dynamic healthcare environment. Drive quality and efficiency in patien...

Shape the future of healthcare by leading a dedicated utilization management team. Oversee clinical reviews and ensure compliance while enhancing member care through effective collaboration and proces...

Join a dynamic team to oversee formulary administration, ensuring compliance and operational excellence. Collaborate with cross-functional teams to implement strategic initiatives and maintain high-qu...

Drive the operational excellence of formulary administration, ensuring compliance and quality control across multiple business lines while collaborating with cross-functional teams to implement strate...

Transform pharmacy outcomes by leading managed care initiatives that optimize clinical programs, enhance stakeholder collaboration, and drive cost efficiencies in pharmacy benefit management...

Drive excellence in patient care by conducting utilization reviews and ensuring compliance with evidence-based guidelines. Collaborate with healthcare teams to assess medical necessity and optimize di...

Empower your career by joining a dynamic Utilization Management team, where you'll leverage your clinical expertise to ensure timely access to behavioral health services, coordinate care, and make a m...

Take ownership of medication therapy management services, conducting comprehensive reviews and consultations. Collaborate with the MTM product team to ensure accurate data entry and enhance patient ca...

Join our team as a Telehealth Pharmacist, where you'll enhance member health through Medication Therapy Management and clinical outreach programs, ensuring high-quality care and compliance with indust...

Drive the development and execution of clinical programs, ensuring effective support, education, and coordination across departments while managing health outcomes and utilization data for continuous...

Unlock potential by leveraging clinical expertise to enhance pharmacy benefit management, analyze drug trends, and build strong client relationships. Drive strategic recommendations and support client...

Drive patient care coordination by collaborating with multidisciplinary teams to ensure safe admissions, effective discharge planning, and compliance with healthcare regulations while advocating for o...

Lead the evaluation of outpatient referrals and inpatient admissions for medical necessity, utilizing guidelines and criteria to ensure quality care. Collaborate with providers and mentor UM nurses to...

Join a team that's redefining operational excellence in healthcare. Lead a diverse team to streamline utilization management processes, enhance technology integration, and drive measurable improvement...

Manage the design and validation of pharmacy benefit plans, ensuring accurate coding and comprehensive client support. Maintain service levels to meet corporate performance and quality standards while...

Shape the future of pharmacy benefit management by ensuring accurate formulary coding and providing exceptional client support. Collaborate with pharmacists and clients to maintain high service levels...

Innovate clinical product strategies by analyzing market data and collaborating across departments. Drive product development and regulatory compliance while enhancing clinical initiatives to ensure c...

Join a dynamic team to lead pricing and underwriting functions, driving financial analysis and risk evaluation. Collaborate with supervisors and analysts to enhance pricing strategies and support clie...

Champion financial performance analysis for specialty pharmacy, collaborating with cross-functional teams to enhance revenue integrity and profitability through actionable insights and strategic recom...

Shape the future of clinical research data integrity by leading a dedicated team. Drive operational excellence, ensure compliance, and foster cross-functional partnerships to enhance data quality and...

Join a dynamic team to coordinate patient admissions and discharges, ensuring quality care and compliance with regulations. Collaborate with healthcare professionals to develop effective care plans an...

Join our dynamic team as a Finance Manager, where you'll lead financial analysis, develop models, and present insights to senior leadership, driving growth and accuracy in financial reporting across t...