At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Coordinator Pharmacy Benefit Location Cleveland Facility Remote Location Department Clinical Integration-EHP-Pharmacy Job Code C15025 Shift Days Schedule 9:30am-6:00pm Job Summary Job Details Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world. The Coordinator – Pharmacy Benefit supports prior authorization processes for EHP, serving as a key resource for members, providers, and pharmacies on prescription coverage and benefit-related inquiries. This role works closely with pharmacists and providers to review and process authorization requests, finalize referrals, and manage communications, including member and provider education. While not involved in dispensing, the coordinator plays a critical role in ensuring timely access to medications, resolving issues, and providing subject matter expertise on pharmacy benefits. The position offers a collaborative environment with opportunities for growth and involvement in new initiatives. This is a remote role in Ohio. A caregiver in this position will work Monday through Friday from 9:30am to 6:00pm with the potential flexible scheduling the future. No holidays, weekends or on-call expectations. A caregiver who excels in this role will: - Respond to physician and member inquires relating to the prescription drug program. - Enter all benefit override requests into an internal database. - Utilize current internal database for pharmacy benefit overrides. - Generate appropriate letters and report and other requests. - Place manual benefit overrides into external vendor's (PBM) computer system. - Comply data and formats this information into the appropriate medium. - Interface with external vendor (PBM) to ensure proper benefit coding and resolve escalated issues. - Ensure proper prescription drug benefit coding and develops solutions to problems that cannot be resolved internally. - Assist the outpatient pharmacy and human resources departments with benefit coverage questions and other copay related issues. - Assist with the implementation and management of pharmacy disease management programs. - Analyze and process other reports to send out mailings or place phone calls to the appropriate members regarding benefit changes. Minimum qualifications for the ideal future caregiver include: - High School Diploma or GED - Knowledge of pharmacy terminology - Certified Pharmacy Technician (CPhT) verified through the Pharmacy Technician Certification Board (PTCB) - Minimum of six months retail pharmacy experience or Pharmacy Technician certification Preferred qualifications for the ideal future caregiver include: - Prior authorization experience Physical Requirements: - Requires frequent computer entry, sitting, standing and walking. - Normal or corrected vision, hearing and speech. Personal Protective Equipment: - Follows standard precautions using personal protective equipment as required. The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances. Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/ Please review the Equal Employment Opportunity poster. Cleveland Clinic is pleased to be an equal employment opportunity employer.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. - Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. - Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care - Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs - Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization - Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. - Typical office working environment with productivity and quality expectations. - Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. - Sedentary work involving periods of sitting, talking, listening. - Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. - Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding. - Effective communication skills, both verbal and written Required Qualifications - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST zones Education Associates Degree required BSN preferred Please replace this section with the Education Requirements Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $29.10 - $62.32 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

It's more than a career, it's a calling WI-REMOTE Worker Type: Regular Job Highlights: Population Health Pharmacy Technician Coordinator This remote role supports the Population Health Pharmacy team by partnering closely with Population Health Clinical Pharmacists to conduct targeted patient outreach aimed at improving quality measures and medication related outcomes. Pharmacy Technician Coordinators help identify barriers to medication adherence, support patients in resolving those barriers, and escalate clinical needs to pharmacists or providers when appropriate. Key Responsibilities • Conduct telephonic outreach to patients identified as non-adherent to hypertension, diabetes, and cholesterol medications based on CMS quality measures. • Collaborate with providers and pharmacists to clarify patient reported medication use and support continuity of care. • Assess and document barriers to adherence (cost, side effects, forgetfulness, transportation challenges, care team changes, etc.). • Provide patients with strategies to improve adherence, including education on extended day supply and other supportive options. • Participate in value based care payer meetings to review performance and discuss opportunities for improvement. • Investigate dispensing history discrepancies to identify dose changes, billing issues, and inconsistent adherence patterns. • Identify patients with cost-related barriers and refer them to the Pharmacy Access Team for assessment of patient assistance program eligibility. • Prioritize outreach based on last fill date and last impactable date to maximize quality outcomes. • Perform other duties as assigned to support population health initiatives. Job Summary: Under the direct supervision of a pharmacist and in accordance with standard procedures, provides coordination and leadership for workflows and process improvement within a specialized operational area that spans multiple ministries. At least 80% of time is dedicated to this focused role, which may include areas such as community operations, technology and automation, regulatory compliance, finance, medication access and adherence, transitions of care, and purchasing. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES - Performs daily services and functions of the specialized role at multiple ministries or in a centralized service model. Interacts in a matrix manner that includes learning multiple workflows for various sites, travel, managing matrix relationships and collaborating across team members and ministries to prioritize and efficiently complete work. Solves issues in the specialized area as they arise. Ensures documents and records are accurate and completed in a timely manner. - Serves as a resource in the specialized area for other regional, system, and/or external stakeholders. Solves complex problems that may impact more than one ministry and ensures that issues are escalated and closed as needed. - Complies with legal, regulatory, and accreditation standards. Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices. Coaches team members across multiple ministries when practice standards are not upheld. - Conducts reviews and audits of specialized area. Reports and monitors KPIs to ensure optimal performance. Identifies quality improvement opportunities based on specialized skill set to ensure safe, effective, and efficient services and patient care. Creates system standardization and leads implementation of operational changes and advancements. Participates in regional or system specialized work teams, committees, and councils. - Collaborates with regional or system leaders to develop and coordinate team member education, training, orientation, and competency. Trains other team members in specialized area. Prepares and distributes work schedules and provides cross-coverage for specialty area, as assigned. - Serves as the multi-ministry or regional liaison to regional or system pharmacy teams in specialty area. Collaborates with leadership to communicate changes in specialty area. - Provides excellent customer service to patients, other staff and ancillary departments and maintains high standards of confidentiality in accordance with the Health Insurance Portability and Accountability Act (HIPAA). - Works in a constant state of alertness and safe manner. - Performs other duties as assigned.  EDUCATION - High School diploma/GED or 10 years of work experience EXPERIENCE - Three years’ experience as a pharmacy technician or relevant healthcare field PHYSICAL REQUIREMENTS - Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. - Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. - Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. - Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. - Frequent keyboard use/data entry. - Occasional bending, stooping, kneeling, squatting, twisting and gripping. - Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. - Rare climbing. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois - Pharmacy Technician, Registered - Illinois Department of Financial and Professional Regulation - (IDFPR) - Or - FUTURE - Pharmacy Technician, Registered within 2 months - Illinois Department of Financial and Professional Regulation (IDFPR) - And - IL Registration Application Process Complete At Time Of Hire - Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri - Pharmacy Technician - Missouri Division of Professional Registration - Or - MO Registration Application and Finger Print Process Complete AT TIME OF HIRE - - Missouri Division of Professional Registration - And - FUTURE - Pharmacy Technician, Registered within 6 months - Missouri Division of Professional Registration State of Work Location: Wisconsin - Pharmacy Technician, Registered - Wisconsin Department of Safety and Professional Services - Or - WI Registration Application Number (PAR) - Wisconsin Department of Safety and Professional Services - And - FUTURE - Pharmacy Technician, Registered within 6 Months - Wisconsin Department of Safety and Professional Services Work Shift: Day Shift (United States of America) Job Type: Employee Department: 8753040033 System Pharmacy Pop Health Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. - Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). - Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. - Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

POSITION SUMMARY: This position is responsible for managing critical portions of workup processes. This includes timely coordination of designated steps in the workup process, workup related documentation, preparation, and completion of forms. ACCOUNTABILITIES: Workup Support and Vendor Management: • Supports the complex database of more than 2,000 vendors, providers, apheresis, and collection centers that aid the clearance and donation process ranging from filgrastim administrators, and third-party physical exam. • Responds to PE or Filgrastim requests from workup staff to locate vendors. If the database has no available PE or Filgrastim resources in the donors’ location. Communicates progress and results in a timely manner to workup staff. • Onboards all new vendors and conducts refresher trainings as needed. This training/onboarding includes an overview of process steps and requirements, review of documents, expected service level agreements, service fees and payment. • Maintains training documents for all vendors in the database to ensure current manufacturing requirements are met. • Supports workup staff by creating Physical Exam or Filgrastim Administration documents. Schedule All Filgrastim Injections: • Monitor DC1WUL mailbox for FA requests from WUS. • Access Salesforce database for current FA providers, or FA providers that may need retraining. • Schedule donor and send paperwork to provider; train/retrain site if necessary; send details of appointment to WUS and enter in notes section of Starlink. Pre-PE Calls: • Receive list of PE’s for following day. Call site to verify paperwork and kits has been received and answer any questions provider has prior to donor’s appointment. Document PE confirmed in Starlink notes. Other Responsibilities: • Performs all duties in compliance with standard operating procedures, National Marrow Donor Program (NMDP) standards, regulations outlined in the Code of Federal Regulations (CFR), Federal Drug Administration (FDA) guidance and other applicable Federal, state, and local laws. Adheres to OSHA guidelines as applicable. • Supports NMDP project teams. • Other duties as assigned based on location of this position. REQUIRED QUALIFICATIONS: Knowledge of: • Demonstrated understanding of business concepts and best office practices, through previous work experience, to include the concept of confidentiality. Ability to: • Demonstrate advanced word processing, intermediate database, Adobe, and Excel spreadsheet software skills. • Demonstrate excellent proofreading and editing, and customer service skills. • Work independently; demonstrate excellent interpersonal, problem solving, oral and written communications skills. • Maintain confidentiality; handle multiple priorities; and demonstrate excellent organization skills. Education and/or Experience: • High school diploma or GED is required. A two year or four-year degree is preferred. Further education may be counted towards minimum experience. • Three years’ administrative experience in a medical, clinical, or regulatory environment that required a variety of duties including the use of word processing, spreadsheet, Adobe, presentation, and database software programs. • One or more years working in a donor center can be substituted for above experience. PREFERRED QUALIFICATIONS: (Additional qualifications that may make a person even more effective in the role, but are not required for consideration) • Experience in a role using medical terminology.