This page tracks remote pharmacist openings that are location-eligible for Pennsylvania.
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170 Jobs
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Reimagining pediatric health care. Together.
• Manage, triage, and assign clinical pharmacy referrals to appropriate clinical pharmacy team member • Support internal and external team members in the clinical pharmacy referral process based on patient needs • Schedule patient/caregiver appointments for pharmacist-driven clinical programs • Prepare charts in advance of Clinical Pharmacist appointments • Communicates with pharmacies, insurance companies, and internal team members to resolve medication access barriers with the support of pharmacist where needed • Completes medication histories • Monitor incoming medication renewal requests and manage per internal protocols, where allowable by state law, and seek assistance when outside renewal protocols • Monitor incoming prior authorization requests and prepare documentation for review by clinical pharmacist • Demonstrates the ability to set priorities, work independently (with pharmacist oversight and review of final product) and cooperatively with others within and outside the department. • Perform other duties as assigned
Arine optimizes medication to ensure each patient is on the safest, most effective therapy for their unique health needs
• We are looking for a Lead Clinical Pharmacist to assist in leading one of the clinical teams that uses the Arine platform to deliver excellent outcomes for our customers. • The Lead Clinical Pharmacist is part of a team of clinicians, analysts, clinical support staff, and trainees utilizing Arine’s software platform to help optimize patient outcomes for our clients. • The purpose of the Lead Clinical Pharmacist position is to assist in managing a patient engagement program that achieves four and five-star results across a variety of Medicare Part C and Part D measures. • The position leads and oversees expert level medication therapy consultation to patients and providers, collaborates with the Engineering team and leadership to improve Arine’s software platform, and supervises a team of Pharmacists who are directly reviewing medication profiles and counseling patients, interacting with other health professionals to help improve patient outcomes. • The Lead Clinical Pharmacist partners with the Clinical Support Lead to achieve results by setting a strategic approach with Arine leadership and with other Clinical Care Leads to drive excellent medication outcomes and by engaging client teams and Arine Customer Success to align expectations and communicate roadblocks and progress.
Arine optimizes medication to ensure each patient is on the safest, most effective therapy for their unique health needs
• Engage patients over the phone to deliver Arine's clinical services, including conducting Medication Therapy Management (MTM) services such as Comprehensive Medication Reviews (CMRs) and Targeted Medication Reviews (TMRs), medication adherence counseling, medication reconciliation, and clinical program education on behalf of their health plan • Review completed medication reviews and counseling by other Virtual Pharmacist users, as assigned • Evaluate, assess, and document patient data in Arine's software platform and other programs; prepare written reports and providing oral reports concerning patient care and team progress • Follow up with clinics, providers, pharmacies, and patients to resolve patient issues and concerns in a timely manner, including transitions of care • Develop intervention strategies to optimize medication utilization, achieve quality measures, and meet other established goals • Manage a consistent volume of patient, provider, and pharmacy interactions while maintaining productivity and service quality • Meet individual and team performance metrics related to outreach, engagement, documentation quality, and clinical outcomes • Adapt and rotate across clinical projects and assignments based on evolving business and client needs • Identify opportunities to improve workflows and Arine's software platform by participating in meetings, collaborating cross-functionally, submitting tickets, and leveraging automation and technology to drive efficiency • Provide daily sign-out and maintaining clear handoff communication to ensure continuity of care • Coach and supporting Clinical Care team members and orienting new Virtual Pharmacist users to workflows and the platform
ArchWell Health aims to transform healthcare for seniors and focuses on quality care, empathy, and community outreach. The company fosters a collaborative cultu
Role Description The Pharmacy Technician is an important colleague of ArchWell Health Pharmacy Team. Reporting to the Clinical Pharmacist, the Pharmacy Technician will be providing direct patient care and collaborating with other healthcare team members in a virtual environment to optimize the pharmaceutical care for our patients. This individual will conduct patient outreaches per existing protocols and assist patients with navigating the medication use aspects, including reviewing components of their plan benefits. An ideal candidate will have a deep understanding of Medicare Advantage prescription benefits, possess strong attention to detail, and be driven by a passion for providing quality care to seniors. Duties/Responsibilities - Conduct telephonic outreaches and answer incoming calls regarding member’s medication use, including but not limited to medication adherence, refill request, and medication clarification. - Obtain member’s permission and place refill requests with pharmacies via phone or web systems. - Access medication adherence gap portals or lists and review member’s medical chart notes to determine appropriate action. - Review and process pharmacy refill requests, either via faxes, EMR routes, or direct incoming calls, per established protocol while meeting the expected turnaround time. - Collaborate with other pharmacy staff, providers, and their care teams as needed to resolve any issues or discrepancies related to medication use. - Ensure that all tasks are completed timely, documented accurately, and in accordance with regulations (including HIPAA) and organizational standards. - Attend staff meetings and provide input into current trends, process evaluation, and quality improvement. - Assist with other pharmacy departmental initiatives as they become available. - Additional duties, as assigned. Qualifications - Excellent customer service and communication skills, including telephone etiquette skills, active listening skills, and the ability to follow-through with patients or staff members. - Ability to work effectively and respectfully with colleagues and diverse populations including members, staff, providers, and family members. - High degree of emotional intelligence and integrity, resilient and focused work ethic, with adaptability to handle frequent changes with a positive attitude. - Self-starter with the ability to think creatively and work effectively. - Strong attention to detail and possessing good alpha/numeric data entry skills with minimal errors. - Intermediate proficiency in Microsoft Office Suite products including Word, Outlook and Excel plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software. - Ability to travel on occasion for company meetings. Requirements - High school diploma or equivalent education (GED) required. - Registered Pharmacy Technician with a state board of pharmacy. - A minimum of 2 years of experience in operational pharmacy benefits (health plan or PBM), clinic setting, high volume call center, or retail pharmacy. - eClinicalWorks or similar EMR experience. - Experience working with geriatric patients or a medication adherence program is a plus. - Bilingual in English/Spanish highly desired. Company Description ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities.
Role Description Are you passionate about serving patients in an inspiring work environment alongside talented people? Get moving with OCR! With over 50 years in business, we are the premier provider of orthopedic care in Colorado, Wyoming, and Nebraska. Our organization continues to grow and we are looking for individuals who share our mission. The Authorization/Benefits Coordinator primarily manages all aspects of the surgical benefits process including: - Verifying patient benefits - Contacting patients regarding eligibility and payment - Entering surgical charges and receipts - Following up on aging receivables - Resolving any issues related to this process This position works closely with insurance coordinators to develop knowledge, communicate changes or adjustments, and resolve issues with patient accounts. This position will have options for remote work and has the potential to work out of other OCR locations. Qualifications - High school diploma or equivalent is required. - Minimum 1 year experience in the insurance or medical industry or equivalent experience with collections in a business/accounting department. - Knowledge of medical terminology preferred. Requirements - Determines patient out-of-pocket expenses using estimates provided by surgery authorization personnel and patient insurance plan. - Notifies patients of determined expenses and establishes payment arrangements per guidelines and department protocols. - Provides prompt support for check-in personnel regarding insurance eligibility issues. - Maintains complete, accurate and up-to-date notes in patient account regarding surgical benefits and pre-authorizations. - Responds to insurance companies’ requests for information in a prompt and professional manner. - Corrects errors in assigned accounts and communicates other account errors to the respective Insurance Coordinator. - Identifies problem accounts on a timely basis and communicates them to supervisor for further action. - Follows up on all denials, claim suspensions, and severe reductions in reimbursement promptly. - Demonstrates consistent collection work by monitoring patient accounts for payment of surgical agreements. - Routinely audits coding and demographical data on visit tickets to ensure the accuracy of claims. - Acts as backup for surgery authorization personnel on an as needed basis. - Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor. - Other duties as assigned. Benefits - Medical, Dental, & Vision coverage - Life and AD&D Insurance - Short- and Long-term disability coverage - Retirement savings and profit-sharing plan participation - Employee Assistance Program - Paid Holidays & Paid Time Off - Company-sponsored events - Annual merit increases *Benefit eligibility is dependent on employment status, and a waiting period may apply.
Arine optimizes medication to ensure each patient is on the safest, most effective therapy for their unique health needs
Role Description We are looking for a Clinical Program Pharmacist to join a strong team of clinicians, data scientists, and engineers to develop and maintain Arine’s software platform and to help optimize patient outcomes for our clients. As a Clinical Program Pharmacist, you will be a part of building a product that helps clinicians provide expert level medication therapy consultation to patients and their providers. You will collaborate closely with Engineering, Product, Implementation, Client Success, and Data Analyst teams to improve Arine’s software platform, and will be expected to supervise and maintain the clinical quality of our product content, as well as assist in clinical program development. You will serve as a liaison for patients and outside providers on product enhancements as the platform expert, and have a direct impact on patient care through the delivery of our core enterprise by keeping continually abreast of new developments in the fast-moving drug field while being aware of emerging patterns, treatment guidelines, and best practices. All team members foster cooperative working relationships with clients and colleagues by communicating effectively, being respectful, and accepting feedback professionally. Additionally, all members act to meet patient needs and learn new skills to achieve quality customer service and patient care. The Clinical Program Pharmacist receives assignments and functions under the supervision of Clinical Program Pharmacist Leads as well as the VP of Clinical Programs to carry out and supervise direct patient care responsibilities and program development. Qualifications - Doctor of Pharmacy (PharmD) from an accredited college/university - Licensed by a Board of Pharmacy and in good standing - Completion of a PGY-1 residency or equivalent experience - Ability to review and assess the appropriateness of medications with respect to age and disease-state specific considerations - Knowledge of chronic disease states, such as diabetes, heart failure, COPD, asthma, cardiovascular disease, hypertension, dyslipidemia, HIV, ESRD, anxiety, depression, bipolar disorders, and thought disorders - Knowledge of the influence of patient’s age, sex, concomitant disease states, concurrent drug therapy, foods and diagnostic procedures on drug activity and disposition - Knowledge of local, state, and federal regulatory requirements related to areas of functional responsibility - Ability to understand and translate clinical guidelines and technical specifications into program design - Has knowledge of prescription and non-prescription drugs and their indications, efficacy, dosage, mechanisms of action, major contraindications and potential side effects - Willingness to be taught/learn new skills - Proven ability to work within technical environments and manage structured data using SQL, Excel, or logic-based tools - Ability to interpret pseudocode and apply systematic logical reasoning to navigate complex technical workflows - Ability to sit at a computer terminal for extended periods of time, with no restrictions for keyboarding - Ability to organize and set priorities which accurately reflect the relative importance of job responsibilities - Excellent communication skills with clients and internal team - Ability to apply judgment and make informed decisions in order to work independently and meet deadlines - Ability to work effectively within a team and foster effective working relationships and build consensus Requirements - Respond to questions from providers, internal and external users, client success, and leadership as the platform subject matter expert - Triage bugs for urgency and priority - Improve clinical algorithms, workflows, and performance metrics based on new quality measures and clinical guidelines - Communicate effectively in both written and oral formats to help interpret and resolve clinical issues or collaborate on new solutions with various stakeholders including but not limited to engineering, product, clinical care team, and clients - Develop intervention strategies to optimize medication utilization, achieve quality measures, and other established goals - Conduct user acceptance testing of clinical outputs - Assist in preparation of customer demonstrations and test new clinical content within the Arine Platform - Comply with all company policies and state and federal rules and regulations Benefits - Dynamic role and the opportunity to contribute to the company's growth and shape its future - Unparalleled learning and growth prospects, collaborating closely with experienced Clinicians, Engineers, Software Architects, and Digital Health Entrepreneurs - Salary range for this position is: $135,000-140,000/year
Creating remarkable health experiences, freeing people to be their best.
• Provide front line staff guidance • Ensure effective and efficient delivery of Pharmacy call center services • Respond to physician and pharmacy network provider inquiries • Review member claims history • Educate and assist pharmacy network providers
• Contributes to Humana’s pharmacy trend detection process by conducting analysis of drug spend, utilization, and/or approval scenarios • Researches and analyzes drugs and emerging therapeutics, including financial forecasts on the web and works with analysts to inform an internal financial forecast for the company • Continuously monitors relevant publicly available news/developments in the pharmaceutical sector, performing any ad hoc analyses and generating insights • Contribute to corporate communications of high quality to be shared with senior leadership such as trend analysis and market event notifications • Partners with pharmacists, data scientists, financial analysts in a team environment • Contributes to developing Humana formulary strategy to mitigate cost trend and improve health outcomes • Contributes to the creation of trend communications to be shared at varying levels within the company, such as, presentations, emails, and executive summaries.
• Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests. • Works with the pharmacy team in implementing policies to manage pharmacy benefits. • Maintains understanding of all policies and procedures related to the pharmacy benefit. • Provides the highest level of customer service and support to members and physicians. • Adheres to all regulatory standards. • Works with Pharmacists to resolve clinical issues with providers in a timely manner. • Documents accurately all inquiries and prior authorization requests according to departmental policy. • Determines appropriateness of pharmacy benefits under corresponding lines of business. • Contacts providers and members to communicate the details of service, requests additional information and resolves outstanding matters. • Updates current pharmacy benefits and serves as a facilitator to team members.
Bringing our heart to every moment of your health.
Role Description CVS Health has an exciting opportunity for a Supervisor, Retail Pharmacy Customer Care to join our growing team. As a Supervisor you will have the ability to provide daily leadership, management, and guidance to the licensed call center staff. Responsible for ensuring superior service to our customers and retail partners by providing information, coaching and feedback to agents. Supports call center service level standards by holding individuals accountable for metrics results. Creates and supports a culture of inclusion and diversity ensuring that actions are in alignment with the CVS policies and values, as well as state, federal and regulatory requirements. - Due to regulatory compliance, work from home opportunities are excluded for residents of: Arkansas, Georgia, Hawaii, Maine, Mississippi, Oklahoma, Puerto Rico, South Carolina, Tennessee, and Washington D.C. Qualifications - Active Pharmacist license in state of residence - Active Pharmacist license in Rhode Island - 3+ years of experience in retail healthcare, preferably in a high-volume call center - 2+ years of experience leading, coaching and developing employees Requirements - Experience in use of call center technologies/applications - Experience in program management - Experience working in a call center environment is highly preferred - Ability to lead diverse work groups in a highly professional and specialized work environment - Ability to assess talent, manage people and motivate others - Strong interpersonal and relationship building skills - Excellent oral, written, and interpersonal communication skills - Experience working in a structured, fast-paced call center environment - Analytical skills - Ability to manage multiple people and priorities simultaneously - Must be able to communicate effectively with all levels and prepare effective written documents Education - Pharmacy Degree (Bachelor's or Doctorate) required Benefits This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include: - Medical, dental, and vision coverage - Paid time off - Retirement savings options - Wellness programs - Other resources, based on eligibility Additional details about available benefits are provided during the application process and on Benefits Moments. Anticipated Weekly Hours - 40 Time Type - Full time Pay Range The typical pay range for this role is: $118,000.00 - $206,250.00. 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. We anticipate the application window for this opening will close on: 06/19/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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