... and 30% remote. The patient members that they will be assessing are dual eligible Medicare ... staff, utilization management staff, health plan partners and contracted providers. RN Field ...
... and 30% remote. The patient members that they will be assessing are dual eligible Medicare ... staff, utilization management staff, health plan partners and contracted providers. RN Field ...
Remote Pharmacist
Columbus, OH · Remote
$56.25 - $67.50/hr
This is a remote, verification-focused pharmacist role responsible for reviewing and verifying ... Receive and manage inbound calls related to order issues and clarifications. * Evaluate medication ...
Remote Pharmacist
Columbus, OH · Remote
$56.25 - $67.50/hr
This is a remote, verification-focused pharmacist role responsible for reviewing and verifying ... Receive and manage inbound calls related to order issues and clarifications. * Evaluate medication ...
Remote Pharmacist
Columbus, OH · On-site +1
$58 - $60/hr
This is a remote, verification-focused pharmacist role responsible for reviewing and verifying ... Receive and manage inbound calls related to order issues and clarifications. * Evaluate medication ...
Remote Pharmacist
Columbus, OH · On-site +1
$58 - $60/hr
This is a remote, verification-focused pharmacist role responsible for reviewing and verifying ... Receive and manage inbound calls related to order issues and clarifications. * Evaluate medication ...
Remote Pharmacist
Columbus, OH · Remote
$56.25 - $67.50/hr
This is a remote, verification-focused pharmacist role responsible for reviewing and verifying ... Receive and manage inbound calls related to order issues and clarifications. * Evaluate medication ...
Remote Pharmacist
Columbus, OH · Remote
$56.25 - $67.50/hr
This is a remote, verification-focused pharmacist role responsible for reviewing and verifying ... Receive and manage inbound calls related to order issues and clarifications. * Evaluate medication ...
Director of Managed Care Remote Position Job Summary: We are seeking an experienced, detail-driven Director of Managed Care to oversee prior authorizations, payer coordination, and utilization ...
Quick apply
Director of Managed Care Remote Position Job Summary: We are seeking an experienced, detail-driven Director of Managed Care to oversee prior authorizations, payer coordination, and utilization ...
REMOTE - Vice President Medical Director of Clinical Programs
New Hampshire, OH · Remote
$286K - $353K/yr
Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical policy, payment policy, and clinical program development. * Lead cross ...
REMOTE - Vice President Medical Director of Clinical Programs
New Hampshire, OH · Remote
$286K - $353K/yr
Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical policy, payment policy, and clinical program development. * Lead cross ...
New Accounts Pharmacist- Illinois
Columbus, OH · Remote
$56.25 - $67.50/hr
Competitive Pay | Remote Flexibility | Career Growth. SpecialtyRx is not your average Long-Term ... Ensure all new account information is accurately entered into the pharmacy management system.
New Accounts Pharmacist- Illinois
Columbus, OH · Remote
$56.25 - $67.50/hr
Competitive Pay | Remote Flexibility | Career Growth. SpecialtyRx is not your average Long-Term ... Ensure all new account information is accurately entered into the pharmacy management system.
New Accounts Pharmacist- Illinois
Columbus, OH · Remote
$56.25 - $67.50/hr
Competitive Pay | Remote Flexibility | Career Growth. SpecialtyRx is not your average Long-Term ... Ensure all new account information is accurately entered into the pharmacy management system.
New Accounts Pharmacist- Illinois
Columbus, OH · Remote
$56.25 - $67.50/hr
Competitive Pay | Remote Flexibility | Career Growth. SpecialtyRx is not your average Long-Term ... Ensure all new account information is accurately entered into the pharmacy management system.
Verification Pharmacist - FuzeRx
Sharonville, OH · On-site +1
$53.50 - $64.25/hr
Operating in a remote capacity, the Verification Pharmacist supports remote verification functions ... Proficiency with pharmacy management systems, electronic prescribing platforms, and verification ...
Verification Pharmacist - FuzeRx
Sharonville, OH · On-site +1
$53.50 - $64.25/hr
Operating in a remote capacity, the Verification Pharmacist supports remote verification functions ... Proficiency with pharmacy management systems, electronic prescribing platforms, and verification ...
PRN Pharmacist - Flexible Coverage
Blue Ash, OH · On-site +1
$56 - $67.25/hr
Remote and on-site support opportunities available Pay: Rate of pay is based on years of experience ... Strong organizational, time management and prioritization skills. * Strong analytical and critical ...
PRN Pharmacist - Flexible Coverage
Blue Ash, OH · On-site +1
$56 - $67.25/hr
Remote and on-site support opportunities available Pay: Rate of pay is based on years of experience ... Strong organizational, time management and prioritization skills. * Strong analytical and critical ...
Fully remote if live >50 miles from Dublin campus What you'll do (Essential Responsibilities ... case management team. Maintain contact with internal clinical staff for transfer of cases for ...
Fully remote if live >50 miles from Dublin campus What you'll do (Essential Responsibilities ... case management team. Maintain contact with internal clinical staff for transfer of cases for ...
Part Time Inpatient Telephonic Staff Pharmacist (Evenings / Overnight) - Remote
New Hampshire, OH · Remote
$53.25 - $62.50/hr
The remote, work from home part-time staff pharmacist provides telepharmacy services to multiple ... Knowledge of formulary management and P&T procedures * Familiarity with client/server applications
Part Time Inpatient Telephonic Staff Pharmacist (Evenings / Overnight) - Remote
New Hampshire, OH · Remote
$53.25 - $62.50/hr
The remote, work from home part-time staff pharmacist provides telepharmacy services to multiple ... Knowledge of formulary management and P&T procedures * Familiarity with client/server applications
Pharmacist - Clinical Applications
Columbus, OH · On-site +1
$107K - $128K/yr
... in medication management and related pharmacy automation with primary focus on accuracy of ... Location: Remote Location Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final ...
Pharmacist - Clinical Applications
Columbus, OH · On-site +1
$107K - $128K/yr
... in medication management and related pharmacy automation with primary focus on accuracy of ... Location: Remote Location Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final ...
Clinical Data Coder
Cincinnati, OH · On-site +1
$18 - $22.75/hr
Work collaboratively with the Medical, Data Management, Safety and Biostatistics teams to meet ... Produce coding reports for team review and utilization *Stable schedule with no weekends, no work ...
Clinical Data Coder
Cincinnati, OH · On-site +1
$18 - $22.75/hr
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Pharmacy Student Clinical Support Specialist - Ohio (Temporary, Part-Time)
Cleveland, OH · Remote
$54.50 - $60.75/hr
The role is remote and offers flexibility, with the ability to complete work during evenings or ... pharmacist and licensed clinical managers to direct patient care. Minimum Qualifications
Pharmacy Student Clinical Support Specialist - Ohio (Temporary, Part-Time)
Cleveland, OH · Remote
$54.50 - $60.75/hr
The role is remote and offers flexibility, with the ability to complete work during evenings or ... pharmacist and licensed clinical managers to direct patient care. Minimum Qualifications
Global Head, Planning & Resource Management - Remote US, UK, Ireland, Poland, Canada ICON is a ... While experience in CRO, pharmaceutical, biotechnology, healthcare, consulting, or other ...
Global Head, Planning & Resource Management - Remote US, UK, Ireland, Poland, Canada ICON is a ... While experience in CRO, pharmaceutical, biotechnology, healthcare, consulting, or other ...
... Remote Field Based). In this role, a typical day will include: * Build disease awareness with key ... Manage the sales budget and grow sales across the territory through development of impactful ...
... Remote Field Based). In this role, a typical day will include: * Build disease awareness with key ... Manage the sales budget and grow sales across the territory through development of impactful ...
This is a remote role supporting the Columbus, OH territory . The position also ensures that the ... Manage the sales budget and grow sales across the territory through development of impactful ...
This is a remote role supporting the Columbus, OH territory . The position also ensures that the ... Manage the sales budget and grow sales across the territory through development of impactful ...
Pre-Construction Support & Constructability Lead - Pharmaceutical Manufacturing
New Albany, OH · On-site +1
Manage and lead pre-construction planning activities across multiple projects and program ... utilization requirements. * Support procurement planning by identifying long-lead equipment ...
Pre-Construction Support & Constructability Lead - Pharmaceutical Manufacturing
New Albany, OH · On-site +1
Manage and lead pre-construction planning activities across multiple projects and program ... utilization requirements. * Support procurement planning by identifying long-lead equipment ...
... management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and ... Remote work eligibility is subject to all work from home criteria met and based on business need ...
... management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and ... Remote work eligibility is subject to all work from home criteria met and based on business need ...
Remote Utilization Management Pharmacist information
What is a remote utilization management pharmacist?
A Remote Utilization Management Pharmacist is a licensed pharmacist who works from a non-traditional setting, such as home, to review medication use and ensure that prescribed drugs are medically necessary, cost-effective, and aligned with clinical guidelines. They collaborate with healthcare providers, insurance companies, and patients to optimize medication therapy while controlling costs and preventing unnecessary treatments. Their work often involves evaluating prior authorization requests, reviewing patient medication histories, and providing recommendations for alternative therapies when appropriate.
How does a remote utilization management pharmacist typically collaborate with other healthcare professionals while working offsite?
Remote Utilization Management Pharmacists work closely with physicians, nurses, and case managers primarily through secure digital platforms and regular conference calls. They review medication requests, provide clinical recommendations, and help ensure patients receive appropriate therapies in line with established guidelines. Effective communication and timely documentation are essential, as collaboration often relies on electronic health records and virtual meetings. Building strong professional relationships remotely can be a challenge, but most organizations provide robust digital tools and dedicated support teams to facilitate seamless interaction.
What are the key skills and qualifications needed to thrive as a remote utilization management pharmacist, and why are they important?
To thrive as a Remote Utilization Management Pharmacist, you need a Doctor of Pharmacy (PharmD) degree, active pharmacist licensure, and experience in medication review and clinical decision-making. Familiarity with pharmacy benefit management (PBM) systems, electronic health records (EHRs), and utilization management software is typically required. Strong analytical skills, attention to detail, and effective written communication are vital for evaluating medication requests and collaborating with healthcare providers. These competencies ensure appropriate medication use, regulatory compliance, and optimal patient outcomes in a remote healthcare setting.
What is the difference between Remote Utilization Management Pharmacist vs Remote Pharmacy Benefits Manager?
| Aspect | Remote Utilization Management Pharmacist | Remote Pharmacy Benefits Manager |
|---|---|---|
| Credentials | Pharmacy license, certification in utilization review | Pharmacy license, health plan or benefits management experience |
| Work Environment | Healthcare organizations, insurance companies, telehealth platforms | Health insurance companies, pharmacy benefit management firms |
| Industry Usage | Focuses on medication review, prior authorizations, and clinical decision support | Oversees pharmacy benefit plans, formulary management, and cost control strategies |
While both roles involve pharmacy expertise and work remotely, the Remote Utilization Management Pharmacist primarily reviews medication appropriateness and manages prior authorizations, whereas the Remote Pharmacy Benefits Manager focuses on managing pharmacy benefit plans and formulary strategies. Understanding these distinctions helps professionals choose the role that best aligns with their skills and career goals.
What are the most commonly searched types of Utilization Management Pharmacist jobs in Ohio?
The most popular types of Utilization Management Pharmacist jobs in Ohio are:
What are popular job titles related to Remote Utilization Management Pharmacist jobs in Ohio?
For Remote Utilization Management Pharmacist jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management Pharmacist jobs in Ohio look for?
The top searched job categories for Remote Utilization Management Pharmacist jobs in Ohio are:
What cities in Ohio are hiring for Remote Utilization Management Pharmacist jobs?
Cities in Ohio with the most Remote Utilization Management Pharmacist job openings:
RN Field Behavioral Health Case Manager
Maumee, OH • Remote
Healthcare Support Staffing •
Recruiting and Staffing Services • 201 - 500 employees201 - 500 employees
Full-time
Re-posted 11 days ago
Job description
Company Description
Are you an experienced Administrative Assistant looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the position for you!
Job Description
RN Field Behavioral Health Case Manager will work 70% in the field and 30% remote. The patient members that they will be assessing are dual eligible Medicare/ Medicaid. There duties include; day-to-day operations of the High Risk Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life. RN Field Behavioral Health Case Manager assess members' current functional level and, in collaboration with the member, develop and monitor the Case Management Treatment Plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the High Risk Case Management functions. Collaborate with both medical and behavioral providers to ensure optimal care for members.
Daily Responsibilities:
RN Field Behavioral Health Case Manager will be responsible for the Lucas County patient members'
Work telephonically with patients identified as high risk to identify needs, set goals and implement action steps towards achieving goals.
Empower patients to help them improve their quality of life.
Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.
RN Field Behavioral Health Case Manager participate in on-going communication between case management staff, utilization management staff, health plan partners and contracted providers.
RN Field Behavioral Health Case Manager will assist with the implementation of policies and procedures regarding case management and utilization management functions.
Working with these members to identify needs and goals to achieve improved quality of life.
Maintain HIPAA compliance.
Qualifications
Requirements:
MUST have a valid RN License in the State of OH
3 years of Behavioral Health experience
3-5 years of case and/or utilization management experience.
CCM (Certified Case Manager) or other clinical certification preferred
Hours for this Position:
Monday - Friday 8 am - 5 pm.
Advantages of this Opportunity:
Competitive salary
Growing Company
Medical benefits go into effect 30 days after start date
Additional Information
If you are interested in applying to this position, please contact Shanna Ramirez, (407) 636-7030 ext. 170 and click the Green "I'm Interested" Button to email your resume.
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
The greatest compliment to our business is a referral.If you know of someone looking for a new opportunity, please pass along my contact information!
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003