Top 121 Clinical pharmacist Jobs in Hopkinton, Ma

Clinical Pharmacist - Appeals and Operations - remote
Fallon Health —Worcester, MA
- $135,000 - $145,000 a year
- Full-time
- Mid-level
- 1 year
- Communication skills
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
Westborough Evening Pharmacist
Advanced Pharmaceutical Consultants, Inc —Westborough, MA
- $58 - $60 an hour
- Part-time
- Mid-level
- In-person
- Communication skills
Quick Apply
Pharmacy Manager – Hematology/Oncology
HV Talent Group —Boston, MA
- $160,000 - $180,000 a year
- Full-time
- Microsoft Excel
- Hospital
- Data analysis skills
Quick Apply
10h
Inpatient Pharmacist
Nora Concierge Care —Cambridge, MA
- $62 an hour
- Contract
- BLS Certification
- Inpatient
- Mid-level
Quick Apply
7d
Pharmacist
Onco360 —Waltham, MA
- From $135,000 a year
- Full-time
- Mid-level
- Bachelor's degree
- Computer skills
- Paid holidays
- Disability insurance
Quick Apply
Clinical Pharmacist
Metrowest Medical Center —Framingham, MA
- Full-time
- Hospital
- Bachelor of Science
- Inpatient
- Health savings account
- Health insurance
6d
Clinical Pharmacist, Ambulatory (Pediatrics), 24hr, Day
UMass Memorial Health —Worcester, MA
- $96,220.80 - $173,180.80 a year
- 8 hour shift
- Hybrid work
- Patient monitoring
- Hospital
- Bachelor of Science
10d
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
Clinical Utilization Management Pharmacist
Point32Health —Canton, MA
- $110,680.66 - $166,020.98 a year
- Full-time
- Microsoft Word
- Bachelor of Science
- Research
- Disability insurance
- Health insurance
Clinical Pharmacy Specialist, Ambulatory (Adult) 40hr, Day
UMass Memorial Health —Worcester, MA
- $101,025.60 - $181,854.40 a year
- 8 hour shift
- Hybrid work
- Hospital
- Mid-level
- Project management
9d
Clinical Pharmacist, Infusion Center Pharmacy, Per Diem
UMass Memorial Health —Worcester, MA
- $46.26 - $83.26 an hour
- 8 hour shift
- Bachelor of Science
- Research
- Mid-level
Clinical Advisor
Rxadvance Corporation —Southborough, MA
- $100,000 - $110,000 a year
- Bachelor's degree
- 1 year
- Senior level
Quick Apply
Clinical Pharmacist MRMC - 24 hr Mixed
UMass Memorial Health —Milford, MA
- $43.90 - $79.02 an hour
- 8 hour shift
- Acute care
- Hospital
- Bachelor of Science
Clinical Pharmacist, Oncology
Boston Children's Hospital —Boston, MA
- $140,649.60 - $225,024.80 a year
- 8 hour shift
- Writing skills
- Mid-level
- Analysis skills
Quick Apply
Pharmacist, Clinical Informatics
Dana-Farber Cancer Institute —Boston, MA
- $150,800 - $159,800 a year
- Full-time
- Bachelor of Science
- Mid-level
- Bachelor's degree
Clinical Pharmacist, Solid Organ Transplant
Boston Children's Hospital —Boston, MA
- $132,683.20 - $212,295.20 a year
- Weekends as needed
- Writing skills
- Mid-level
- Analysis skills
3d
Clinical Pharmacist
Beth Israel Lahey Health —Milton, MA
- $57.00 - $76.71 an hour
- Full-time
- Hospital
- Patient care
- Hospital experience
Clinical Staff Pharmacist Per Diem Mail Order
Beth Israel Lahey Health —Westwood, MA
- $58.00 - $73.56 an hour
- Call employer
- Microsoft Excel
- Microsoft Outlook
- Hospital
Clinical Pharmacist (Per Diem)
Beth Israel Lahey Health —Needham, MA
- $57.00 - $76.71 an hour
- Call employer
- Hospital
- Inpatient
- Mid-level
10d

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clinical pharmacist jobs near hopkinton, ma

Clinical Pharmacist - Appeals and Operations - remote

Fallon Health -
Worcester, MA

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Job Details

Full-time
$135,000 - $145,000 a year

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.

Pay 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 hopkinton, ma

Clinical Pharmacist - Appeals and Operations - remote

Pharmacy Manager, Hematology/Oncology

Westborough Evening Pharmacist

Pharmacy Manager – Hematology/Oncology

Inpatient Pharmacist

Pharmacist

Clinical Pharmacist

Clinical Pharmacist, Ambulatory (Pediatrics), 24hr, Day

Clinical Staff Pharmacist Mail Order

Clinical Utilization Management Pharmacist

Clinical Pharmacy Specialist, Ambulatory (Adult) 40hr, Day

Clinical Pharmacist, Infusion Center Pharmacy, Per Diem

Clinical Advisor

Clinical Pharmacist MRMC - 24 hr Mixed

Clinical Pharmacist, Oncology

Pharmacist, Clinical Informatics

Clinical Pharmacist, Solid Organ Transplant

Clinical Pharmacist

Clinical Staff Pharmacist Per Diem Mail Order

Clinical Pharmacist (Per Diem)

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