Alignment Health
501 - 1000 employees
Founded 2013
⚕️ Healthcare Insurance
👥 B2C
💰 $321.1M Post-IPO Debt - Alignment Health on 2024-11
Healthcare Insurance • B2C
Alignment Health is a Medicare-focused health insurance company that offers Medicare Advantage plans and member-centered services. It provides 24/7 on-demand access to care via in-person, in-home, and mobile channels and features a concierge-style on-demand card to help members schedule appointments, arrange transportation, and answer health questions. Alignment Health partners with brokers, providers, Accountable Care Organizations (ACOs), and institutional partners, operates in multiple U. S. states (including Arizona, California, Nevada, North Carolina, and Texas), and has earned high CMS ratings and industry recognition.
Clinical Pharmacist I
🕒 June 24
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Alignment Health
501 - 1000 employees
Founded 2013
⚕️ Healthcare Insurance
👥 B2C
💰 $321.1M Post-IPO Debt - Alignment Health on 2024-11
Healthcare Insurance • B2C
Alignment Health is a Medicare-focused health insurance company that offers Medicare Advantage plans and member-centered services. It provides 24/7 on-demand access to care via in-person, in-home, and mobile channels and features a concierge-style on-demand card to help members schedule appointments, arrange transportation, and answer health questions. Alignment Health partners with brokers, providers, Accountable Care Organizations (ACOs), and institutional partners, operates in multiple U. S. states (including Arizona, California, Nevada, North Carolina, and Texas), and has earned high CMS ratings and industry recognition.
📋 Description
• Review and render Part D coverage determination and appeal requests • Conduct comprehensive medication reviews via telephone for members enrolled in the MTM program • Participate in pharmacy quality improvement projects aligned with Medicare Star Ratings • Maintain appropriate records of all clinical reviews, coverage determinations, and consultations
🎯 Requirements
• Minimum of 1 year of experience working at a health plan, Pharmacy Benefit Manager (PBM), or in a managed care pharmacy setting • In-depth understanding of CMS Medicare Part D coverage determination and appeal processes • Proficiency in conducting CMR and TMR reviews • Bachelor's degree in Pharmacy or a related health science field • Active and unrestricted Pharmacist license in applicable state(s)
🏖️ Benefits
• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Opportunities for professional development
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