Top 133 Clinical pharmacist Jobs in Acton Ma

Clinical Pharmacist -Appeals and Operations Support- Growing Healthcare Organization
Fallon Health —Worcester, MA
- $135,000 - $145,000 a year
- Full-time
- Mid-level
- 1 year
- Communication skills
1d
Clinical Pharmacist (Critical Equipment/Automation)
US Veterans Health Administration —Chelmsford, MA
- $137,786 - $179,126 a year
- Online Application
- Background check
- Bachelor of Science
- Pass drug screening
6h
Pharmacist 2nd shift
Clarest Health —Southborough, MA
- $130,000 - $135,000 a year
- Full-time
- Mid-level
- Team management
- Mentoring
- Health insurance
- Dental insurance
Quick Apply
Arbor Per Diem Pharmacist Weekdays
Advanced Pharmaceutical Consultants, Inc —Jamaica Plain, MA
- $60 an hour
- Part-time
- Data entry
- In-person
- Communication skills
- 401(k)
- Employee assistance program
Quick Apply
Westborough Evening Pharmacist
Advanced Pharmaceutical Consultants, Inc —Westborough, MA
- $58 - $60 an hour
- Part-time
- Mid-level
- In-person
- Communication skills
Quick Apply
10d
Per Diem Outpatient Pharmacist
St. Joseph Hospital —Nashua, NH
- $49.39 - $68.02 an hour
- Per diem
- Hospital
- Mid-level
- Outpatient experience
10d
Staff Pharmacist
Koala Health, LLC —Boston, MA
- $60 - $65 an hour
- Online Application
- Background check
- Customer service
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Director of Pharmacy
TaraVista —Devens, MA
- $130,000 - $155,000 a year
- Full-time
- 5 years
- Senior level
- Leadership
- AD&D insurance
- Disability insurance
Quick Apply
Pharmacy Manager, Hematology/Oncology
RCM Health Care Services —Boston, MA
- $160,000 - $180,000 a year
- Full-time
- Analysis skills
- Bachelor's degree
- Mentoring
Quick Apply
Pharmacist (Allied)
Software Technology Inc —Burlington, MA
- Weekends as needed
- Mid-level
- Outpatient experience
- Epic
Quick Apply
Pharmacist
Onco360 —Waltham, MA
- From $135,000 a year
- Full-time
- Mid-level
- Bachelor's degree
- Paid holidays
- Disability insurance
Quick Apply
Pharmacist
Greater Lawrence Family Health Center —Lawrence, MA
- Part-time
- Spanish
- BLS Certification
- Internal Medicine
- Tuition reimbursement
Quick Apply
Staff Pharmacist
Vital Care of Cambridge —Cambridge, MA
- $75 - $85 an hour
- Part-time
- Background check
- Bachelor of Science
- Research
- Health savings account
- Health insurance
Quick Apply
Clinical Pharmacist, Framingham Infusion Center
Tufts Medical Center —Framingham, MA
- $114,400.00 - $141,756.53 a year
- Weekends as needed
- Microsoft Excel
- Mid-level
- Outpatient experience
- Health insurance
Clinical Pharmacist Specialist Anticoagulation Onsite / Remote (Burlington, MA.)
Beth Israel Lahey Health —Burlington, MA
- $127,987 - $162,318 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Hospital
Clinical Pharmacist, Ambulatory (Adult), 40hr, Day
UMass Memorial Health —Worcester, MA
- $94,660.80 - $170,414.40 a year
- 8 hour shift
- Hybrid work
- Bachelor of Science
- Mid-level
- Outpatient experience
Clinical Pharmacist- Outpatient Prescription Center, Per Diem
UMass Memorial Health —Worcester, MA
- $46.26 - $83.26 an hour
- 8 hour shift
- Bachelor of Science
- Research
- Mid-level
8d
Clinical Pharmacist II – Per Diem
Beth Israel Lahey Health —Burlington, MA
- $59.74 - $80.40 an hour
- Call employer
- Hospital
- Customer service
- Mid-level
Clinical Pharmacist, Inpatient Operations 32 hours
Boston Children's Hospital —Boston, MA
- $106,146.56 - $169,836.16 a year
- Part-time
- Hospital
- Inpatient
- Mid-level
7d
Clinical Staff Pharmacist Mail Order
Beth Israel Lahey Health —Westwood, MA
- $123,760.00 - $166,566.40 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Hospital

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clinical pharmacist jobs near acton ma

Clinical Pharmacist -Appeals and Operations Support- Growing Healthcare Organization

Fallon Health -
Worcester, MA

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Job Details

Full-time
$135,000 - $145,000 a year
1 day ago

Qualifications

Presentation software
Managed care
Managed care organization experience
Clinical pharmacy experience
Clinical information systems
Cross-functional communication

Full Job Description

Overview:

About us:

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose:

Review and provide clinical decisions/recommendations for provider/member submitted appeals and grievances for medically administered medications as well as pharmacy related medications and items for all lines of business.
Analyze pharmacy data (appeal approval/denial rates, claims, clinical, formulary, financial, etc.) to assist with UM development.
Assist with formulary development for all lines of business.
Provide clinical assistance to pharmacy staff for daily operations.

Responsibilities:

Primary Job Responsibility

Responsible for reviewing and providing clinical decisions/recommendations for provider/member submitted appeals and grievances for medically administered medications as well as pharmacy related medications and items for all lines of business.
Collaborate with the Appeals & Grievance Department, Medical Directors, and Prior Authorizations vendors.
Maintain turnaround times for all appeal and grievance reviews.
Review appeal/grievance requests per plan-specific criteria, MassHealth-developed criteria, National Coverage Determinations, and Local Coverage Determinations, Evidence of Coverage, Member Handbooks.
Follow regulatory rules and processes for Massachusetts, CMS, Medicaid, state Connector programs.
Consult with internal and external stakeholders as needed.
Consult with providers.
Participate in managing clinical issues resolution; work with medical providers and vendors to coordinate and resolve member issues.
Provide recommendations, as appropriate, to update current prior authorization criteria due to appeals and grievance data.
Assist with formulary and criteria development for all lines of business.
Participate in general drug information support for internal and external clients.
Provide clinical assistance to pharmacy staff for daily operations.

Qualifications:

Qualifications requirements

Education

RPH or Pharm D

License

Current license to practice as pharmacist in Massachusetts without restriction

Experience

3 years, preferably with at least 1 year in a managed care environment; 1-2 years professional experience practicing as a clinical pharmacist.
Recent experience related to member and/or provider appeals and drug coverage determinations is a plus.
Able to evaluate clinical pharmacy data, coverage criteria and drug monographs.
Able to understand and use computer databases, EMRs, Excel, Word, PowerPoint and others.
Able to write and orally communicate clinical decisions to physicians and other healthcare personnel.
Excellent communication skills, coordination, and planning skills along with an ability to interact with a variety of audiences to build collaboration and consensus.

Salary Range Disclosure:
In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $135,000-$145,000 annually which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

#P01

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Refine Your Search

clinical pharmacist jobs in acton ma

Clinical Pharmacist -Appeals and Operations Support- Growing Healthcare Organization

Clinical Pharmacist (Critical Equipment/Automation)

Pharmacist 2nd shift

Arbor Per Diem Pharmacist Weekdays

Westborough Evening Pharmacist

Per Diem Outpatient Pharmacist

Staff Pharmacist

Director of Pharmacy

Pharmacy Manager, Hematology/Oncology

Pharmacist (Allied)

Pharmacist

Pharmacist

Staff Pharmacist

Clinical Pharmacist, Framingham Infusion Center

Clinical Pharmacist Specialist Anticoagulation Onsite / Remote (Burlington, MA.)

Clinical Pharmacist, Ambulatory (Adult), 40hr, Day

Clinical Pharmacist- Outpatient Prescription Center, Per Diem

Clinical Pharmacist II – Per Diem

Clinical Pharmacist, Inpatient Operations 32 hours

Clinical Staff Pharmacist Mail Order

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