Screens and identifies members with high risk, long term chronic conditions who will benefit from care management services. Monitors utilization as needed. Referrals for cases may originate from various sources Performs member evaluations and onsite visits as needed in multiple settings, including but not limited to telephonic, member's homes, PCP/Specialists clinic, hosp

Develop models and self service tools to provide to leadership with actionable timely insights into margin trends and opportunities Analyze monthly reporting that provides insight into the revenue and cogs dynamics of the business Support business strategy and initiatives through analysis of therapy cost structure and understanding of impact to margin Generating annual fi

Actively engage leadership and staff at all levels to enhance the patient, staff and provider service experience Collaborate with market leadership to foster an environment that supports high levels of patient, staff and provider engagement in improving patient experience Develop training programs, localized strategies, unit/department based activities to increase awarene

Oversee and be responsible for behavior support services provided to individuals receiving LTSS (long term services and supports) and comparable populations Responsible for working with the BH CMO to oversee the ongoing management of behavior crisis prevention, intervention, and stabilization services Responsible for working with the other medical officers and the Pharmac

Provide clinical support and mentorship to DOPs in their execution of roles and responsibilities, auditing performance for appropriate clinical documentation; policy & procedure compliance; response to audits/inspections; and management of unexpected branch issues/quality related/adverse events Supports DOP oversight of clean room suite (CRS) function, including facility

This individual will be responsible to deploy a new demand forecasting and supplier collaboration system by Q4 of 2024 Requires a deep knowledge of S&OP process, forecasting systems, inventory planning, and matching demand with supply Develops and executes a clear demand planning strategy for the business and manages a high performing team charged with all aspects of dema

2+ years of providing formal client presentations Proficiency in Microsoft Word, Excel, PowerPoint, Teams, and Outlook Willing and ability to travel up to 15% Preferred Qualifications ASHP/AMCP accredited residency in Managed Care 5+ years of managed care or PBM experience Experience working with Health Plan clients Experience working with Commercial, Medicare and Exchang

Assess the training and organizational development needs within a function (e.g. claims) Participate in the development of training programs and classroom materials Provide leadership within the classroom or virtual classroom environment Report training metrics and generate training related reports Keeping pace with our instructional needs will be the biggest challenge fo

Distributes drugs prescribed by physicians and other health practitioners Provides information to consumers about medications and their use Focuses on providing a superior level of customer service. Ensures compliance with all relevant laws of the applicable State Board of Pharmacy Administration of immunizations as allowed by State Boards of Pharmacy Per Diem pharmacist

Perform aseptic compounding of medications in compliance with USP and guidelines, ensuring accuracy and safety in every preparation Travel to different pharmacy locations to provide expertise in sterile compounding techniques and assist in addressing operational needs Availability to step into different branches as an interim support, establish routines, create resolution

Perform counseling support and education with patients related to their medication(s) and disease state(s) at designated intervals following a standard operating procedure Identification and accurate, timely completion of adverse event reporting Use the Pharmacists' Patient Care Process (PPCP) to manage the process and improve patient clinical outcomes Provide follow up w

Greets patients and escorts them to exam room. Performs hand washing, weighs patients, takes vital signs and patient history, and documents chief complaint. May administer limited injections requested by a physician and supervised by a physician, registered nurse, nurse practitioner or physician assistant in accordance to established regulations, in conjunction with atten