Utilization Management Pharmacist Jobs in San Diego, CA

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...

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...

Champion patient care by coordinating complex hospitalizations, utilizing critical thinking and discharge planning skills to enhance outcomes and streamline processes across multidisciplinary teams in...

Drive patient care excellence by coordinating complex hospitalizations, utilizing critical thinking and discharge planning skills. Collaborate with healthcare teams to ensure efficient, cost-effective...

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...

Educate healthcare providers on patient support programs and reimbursement strategies, addressing access barriers while navigating payer landscapes. Collaborate with internal teams to ensure complianc...

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...

Champion the global supply chain for clinical trials, ensuring timely availability of ancillary materials. Collaborate with cross-functional teams to manage logistics, mitigate risks, and support unin...

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...

Champion quality performance initiatives by collaborating across departments to enhance healthcare outcomes through data analysis, project management, and compliance with regulatory standards, ensurin...

Unlock innovative healthcare solutions by leading product strategy and lifecycle management for clinical programs. Collaborate across teams to enhance member experiences and drive business value while...

Lead the charge in developing and executing drug formulary strategies, ensuring compliance with regulations while collaborating with cross-functional teams to enhance pharmacy utilization management a...

Lead the sales strategy for a healthcare Payer business unit, driving market penetration, revenue growth, and client satisfaction. Collaborate with leadership to shape go-to-market strategies and buil...