
1001 - 5000 employees
Founded 30+ years
🏥 Healthcare
🛡️ Insurance
⚕️ Healthcare Insurance
Healthcare • Insurance • Healthcare Insurance
CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.
🔥 12 hours ago
🎰 Nevada – Remote
💵 $35.9k - $57.3k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
💊 Pharmacist
🦅 H1B Visa Sponsor
👻 Ghost score 0%
Where this job comes from
Posted on CareSource's careers page, not through a job board
First seen by Remote Rocketship 12 hours ago
Still open on CareSource's site. Checked 1 hour ago.

1001 - 5000 employees
Founded 30+ years
🏥 Healthcare
🛡️ Insurance
⚕️ Healthcare Insurance
Healthcare • Insurance • Healthcare Insurance
CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.
• Review traditional and specialty medication prior authorization requests for members’ pharmacy benefits submitted by providers • Send fax communications to providers when necessary • Contact provider offices to follow up on failed faxes • Educate CareSource providers about resources outlining formulary alternatives • Place prior authorizations in the prior authorization system(s) when approval is appropriate • Initiate routing of prior authorizations requiring pharmacist review • Answer provider calls regarding prior authorization requests, prescription coverage, and formulary issues • Perform outbound calls to obtain information from providers and/or pharmacies • Document all telephonic interactions in appropriate systems • Ensure fax, email, ePA, and other submissions are answered within the state-mandated period • Participate in special projects reviewed by management when needed • Answer calls and troubleshoot issues from retail and specialty pharmacies • Assist Case Managers, Member and Provider Services with pharmacy issues, overrides, and questions • Monitor current workload aging and respond with appropriate urgency • Maintain knowledge of processes and procedures for all markets on faxes and phones • Adhere to departmental and company policies and procedures • Perform other job duties as requested
• High School Diploma or equivalent years relevant work experience is required • Three (3) years retail pharmacy or hospital pharmacy experience is preferred • One (1) year managed care prior authorization experience is preferred • Computer proficient with knowledge in a “Windows” environment • Beginners level Microsoft Word, Outlook, and Excel • Must type 40 words per minute (WPM) • Professional level telephone communication skills • Familiarity with medical terminology • Familiarity with medication names • Excellent communication skills when speaking to providers offices, as well as pharmacies • Ability to work independently and within a team environment • Ability to train/teach new employees within the department • Attention to detail • Familiarity of the healthcare field • Knowledge of Medicaid/Marketplace • Critical listening and thinking skills • Proper grammar usage • Time management skills • Proper phone etiquette • Customer service oriented • Decision making/problem solving • Leadership experience and skills • Pharmacy Technician Certification is preferred • Ability to acquire state registration in multiple states, as required • Ability to work any shift between 7am and 9pm • Flexibility to work weekends and overtime, as needed
• Bonus tied to company and individual performance • Substantial and comprehensive total rewards package • Employee total well-being support
Apply NowImprove your chances of getting an interview by checking your resume score before you apply.
🔥 13 hours ago
Epic pharmacist optimizing electronic medication systems for McLeod Health, a nonprofit hospital network. Supporting pharmacy staff, clinicians, patient safety, and IT initiatives.
🔥 13 hours ago
Pharmacy prior authorization representative processing fertility prescriptions, insurance benefits, and appeals for Evernorth Health Services. Supporting patients, providers, and clinic teams across AZ, IL, and MA.
🕒 Yesterday
Clinical pharmacist providing ambulatory medication management for cardiometabolic and medical weight-loss patients at UMass Memorial Health. Optimizing therapy, safety, adherence, and outcomes remotely.
🇺🇸 United States – Remote
💵 $98.9k - $177.9k / year
💰 $4.7M Grant on 2022-12
⏰ Full Time
🟡 Mid-level
🟠 Senior
💊 Pharmacist
🕒 Yesterday
Associate Director leading Humana’s Pharmacy Stars programs to improve Medicare medication use. Overseeing clinical strategies, quality measures, and pharmacy teams.
🕒 Yesterday
Remote specialty pharmacist verifying prescriptions and supporting Parkinson’s therapies and IVIG infusions. Providing counseling, care plans, clinical monitoring, and pharmacy quality oversight for Centene patients.