Utilization Management Pharmacist Jobs in San Diego, CA

Unlock member value by managing pharmacy solutions, optimizing contract use, and fostering relationships with healthcare systems to enhance operational efficiency and savings...

Drive accurate, evidence-based clinical claims while collaborating with Marketing, Legal, and Clinical teams. Build and manage the claims framework and evidence library to support bold, compliant mark...

Champion student mental health by providing acute care case management services. Collaborate with a diverse team to support students facing mental health crises, ensuring access to essential resources...

Join our team to manage provider networks, ensuring seamless operations and exceptional service. You'll handle credentialing, provider relations, and data analysis, contributing to the integrity of ou...

Shape the future of managed care by leading contract negotiations, performance monitoring, and strategic initiatives to optimize reimbursement and enhance payer relationships across healthcare service...

Drive the end-to-end Medi-Cal revenue cycle by designing workflows, ensuring compliance, and fostering collaboration among clinical, billing, and finance teams to enhance efficiency and accuracy in cl...

Optimize compliance and revenue management across healthcare facilities, ensuring adherence to state and federal reimbursement regulations while enhancing financial performance through strategic analy...

Join a team that's dedicated to enhancing patient care through expert pharmaceutical services. You'll engage with customers, provide essential medication counseling, and ensure compliance while leadin...

Develop and lead comprehensive benefits and compensation programs, ensuring alignment with business goals and enhancing employee experience through strategic management and continuous improvement init...

Join a dynamic team to evaluate and process medication prior authorization requests, ensuring compliance with clinical guidelines and regulatory standards while facilitating timely patient access to n...

Engage with healthcare providers to enhance pharmacy relationships, deliver education, and support services. Drive outreach initiatives and organize health fairs, ensuring alignment with patient and p...

Lead the charge in driving operational excellence and strategic direction for a high-performing underwriting team, ensuring quality Medicare underwriting services that support profitable growth and bu...

Empower our channel partner division by managing operational activities, coordinating RFPs, and driving cross-functional collaboration to enhance sales and partner engagement. Your insights will shape...

Unlock potential by leading strategic government programs, managing P&L, and driving operational excellence. Oversee contract delivery, mentor staff, and foster client relationships to ensure growth a...

Shape the future of data solutions by leading complex pharmacy claims and physician-level data integrations. Collaborate with cross-functional teams to deliver high-quality, scalable solutions that me...

Join us in leading product strategy and execution for a diverse portfolio, enhancing Provider Contracting and Credentialing. Collaborate with cross-functional teams to drive innovation, improve custom...

Transform billing operations by leading a team to optimize healthcare revenue cycle processes, ensuring timely and accurate claims submission while driving performance improvements and fostering stron...

Drive impactful projects by collaborating across teams to enhance operational efficiency and deliver innovative solutions. Leverage your expertise to influence strategic decisions and contribute to a...

Manage all facets of a federal travel program, ensuring compliance and efficiency in a high-volume environment. Drive improvements in processes and provide urgent support for travelers, while maintain...

Champion the end-to-end management of complex healthcare programs, ensuring operational readiness and compliance. Collaborate with teams and clients to drive successful implementations while maintaini...

Lead the charge in managing comprehensive accounting functions for self-insurance groups, ensuring accurate financial reporting, compliance with regulations, and effective budget management while coll...

Drive customer success by managing complex onboarding projects, ensuring alignment across teams, and delivering high-quality implementations. This role is pivotal in creating structured processes in a...

Elevate project outcomes by leading cross-functional teams to deliver clinical research projects on time and within budget, ensuring compliance with regulatory standards and client expectations while...

Oversee the quality assurance of case reviews, ensuring accuracy and completeness in documentation while collaborating with clinicians to uphold high standards in healthcare determinations and workflo...

Accelerate progress at the forefront of clinical research by ensuring effective oversight and management of clinical studies. Collaborate with teams to uphold quality standards and drive successful st...