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Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for 30+ years and we continue to be a transformative force in the industry by placing people over profits. 

CareSource is and will always be member-first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to over 2.3 million members through plan offerings including Marketplace, Medicare products and Medicaid. With our team of 4,500+ employees located across the country, we continue to clear a path to better life for our members. Visit the "Life"​ section to see how we are living our mission in the states we serve.

Finance

CareSource

You must have a Bachelor's in Pharmacy, 3 years of retail experience, 1-year managed care experience, RPh licensure, strong communication, and time management skills, plus proficiency in Microsoft Office.

You will evaluate Prior Authorization requests, communicate decisions, engage providers, assist call center staff, ensure operational efficiency, and maintain quality while meeting productivity goals.

Legal

Healthcare

Job Summary<br><br>Pharmacist I is responsible for supporting the department, operational strategies, goals and vision. Pharmacists shall utilize pharmaceutical and clinical expertise to review Prior Authorizations requests within a timely manner, to promptly serve our CareSource members.<br><br>Essential Functions<br><br><br> * Supports and participates in Prior Authorization (PA) Reviews by documenting, implementing and utilizing the following: Formulary Management guidelines, Utilization Management programs, CareSource Administrative and Operational policies and procedures, and/or other clinical programs<br> * Execute critical thinking and decision processes when evaluating PA Reviews for Pharmacy and Medical Benefit medications<br> * Conduct PA Reviews for Multi-State Medicaid and Marketplace lines of business<br> * Provide written communications to members and providers upon decisioning of PA requests<br> * Engage Providers in “Peer to Peer” discussions, and Clinical Consults, as requested<br> * Assist Pharmacy PA call center staff<br> * Provide support and collaborate with pharmacy technicians to ensure operational efficiencies<br> * Adhere to Turn Around Time (TAT) requirements, per Line of Business<br> * Observe Operational Productivity Goals and Metrics<br> * Maintain exceptional quality<br> * Cross-collaborate with Departmental and Organizational Teams<br> * Perform any other job duties as requested<br>   <br>   <br><br>Education And Experience<br><br><br> * Bachelor’s Degree in Pharmacy is required; Doctor of Pharmacy (PharmD) is preferred<br> * Minimum of three (3) years of retail pharmacy experience is preferred<br> * Minimum of one (1) year managed care or Medicare experience is preferred<br>   <br>   <br><br>Competencies, Knowledge And Skills<br><br><br> * Working knowledge of Microsoft Outlook, Teams, Word, Excel, and PowerPoint<br> * Familiarity with the healthcare field, including Insurer, PBM, Specialty or Retail Pharmacy and Provider<br> * Understanding Managed Care and/or Retail Pharmacy operations with respect to Medicaid, Marketplace and /or Medicare<br> * Proficient in medical terminology, medication names, generics and biosimilars<br> * Application of Clinical guidelines, policies, and decision trees/tools<br> * Understanding the pharmacist’s clinical role in the care of members; utilization of Clinical expertise<br> * Strong written and verbal Communication skills, including use of proper grammar in print and e-mail communications<br> * Ability to simplify clinical language for lay persons<br> * Critical listening, thinking and problem-solving skills<br> * Attention to detail<br> * Organized and learns quickly<br> * Comfortable working in a fast-paced environment<br> * Time management skills<br> * Use of proper phone etiquette<br> * Ability to work independently and within a team environment<br>   <br>   <br><br>Licensure And Certification<br><br><br> * Current, unrestricted Registered Pharmacist (RPh) licensure is required<br> * Ability to acquire additional State License(s) in multiple states, as required<br>   <br>   <br><br>Working Conditions<br><br><br> * General office or Remote work environment; may be required to sit or stand for extended periods of time<br>   <br>   <br><br>Compensation Range<br><br>$83,070.00 - $145,440.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.<br><br>Compensation Type<br><br>Salary<br><br>Competencies<br><br><br> * Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business<br>   <br>   <br><br>This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.<br><br>

Job SummaryPharmacist I is responsible for supporting the department, operational strategies, goals and vision. Pharmacists shall utilize pharmaceutical and clinical expertise to review Prior Authorizations requests within a timely manner, to promptly serve our CareSource members.Essential Functions * Supports and participates in Prior Authorization (PA) Reviews by documenting, implementing and utilizing the following: Formulary Management guidelines, Utilization Management programs, CareSource Administrative and Operational policies and procedures, and/or other clinical programs * Execute critical thinking and decision processes when evaluating PA Reviews for Pharmacy and Medical Benefit medications * Conduct PA Reviews for Multi-State Medicaid and Marketplace lines of business * Provide written communications to members and providers upon decisioning of PA requests * Engage Providers in “Peer to Peer” discussions, and Clinical Consults, as requested * Assist Pharmacy PA call center staff * Provide support and collaborate with pharmacy technicians to ensure operational efficiencies * Adhere to Turn Around Time (TAT) requirements, per Line of Business * Observe Operational Productivity Goals and Metrics * Maintain exceptional quality * Cross-collaborate with Departmental and Organizational Teams * Perform any other job duties as requested      Education And Experience * Bachelor’s Degree in Pharmacy is required; Doctor of Pharmacy (PharmD) is preferred * Minimum of three (3) years of retail pharmacy experience is preferred * Minimum of one (1) year managed care or Medicare experience is preferred      Competencies, Knowledge And Skills * Working knowledge of Microsoft Outlook, Teams, Word, Excel, and PowerPoint * Familiarity with the healthcare field, including Insurer, PBM, Specialty or Retail Pharmacy and Provider * Understanding Managed Care and/or Retail Pharmacy operations with respect to Medicaid, Marketplace and /or Medicare * Proficient in medical terminology, medication names, generics and biosimilars * Application of Clinical guidelines, policies, and decision trees/tools * Understanding the pharmacist’s clinical role in the care of members; utilization of Clinical expertise * Strong written and verbal Communication skills, including use of proper grammar in print and e-mail communications * Ability to simplify clinical language for lay persons * Critical listening, thinking and problem-solving skills * Attention to detail * Organized and learns quickly * Comfortable working in a fast-paced environment * Time management skills * Use of proper phone etiquette * Ability to work independently and within a team environment      Licensure And Certification * Current, unrestricted Registered Pharmacist (RPh) licensure is required * Ability to acquire additional State License(s) in multiple states, as required      Working Conditions * General office or Remote work environment; may be required to sit or stand for extended periods of time      Compensation Range$83,070.00 - $145,440.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.Compensation TypeSalaryCompetencies * Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business      This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

REMOTE - Pharmacist I - R8621 - CareSource

United States

REMOTE - Pharmacist I - R8621

You need a Bachelor’s degree, 2+ years in HR, familiarity with Workday and Qualtrics, Microsoft Office skills, strong communication, and problem-solving abilities. PHR certification is a plus.

You will manage employee experience processes, support performance reviews, enhance onboarding, oversee recognition programs, analyze feedback data, and drive continuous improvements while handling multiple projects.

Consulting

People, HR & Administration

Dayton

<div><div>Job Summary:</div><div></div><div>
The Employee Experience Specialist I is responsible for supporting the implementation of performance and employee experience processes that cultivate a positive, inclusive, employee experience and position CareSource as an employer of choice. This role will work closely with peers across the HR organizational functions to execute priorities and deliverables.</div><div></div><div>
Essential Functions:</div><ul><li>
Responsible for successful administration of processes supporting the implementation of the CareSource employee experience strategy</li><li>
Support the execution of the annual performance process, including goal setting, mid-year and year-end reviews with a focus on reviewing and testing system enhancements, updating resources and support tools, reporting and timely responses to questions, and issue resolution</li><li>
Participate in the buildout, dashboard/data reporting related to candidate, life cycle and employee experience surveys to drive a culture of feedback, development, and inclusion across the organization</li><li>
Collaborate on the design and implementation of new employee experience process/resource enhancements to streamline an accelerate the integration of new employees into the organization</li><li>
Support the execution of the Employer of Choice strategy by collaborating on data collection and management needs</li><li>
Responsible for timely, accurate and effective administration of employee recognition platforms, processes and reporting to support the successful implementation of the overall employee recognition strategy</li><li>
Develop and maintain project and implementation plans for Employee Experience processes and initiatives on as needed basis</li><li>
Contribute to the ongoing evaluation and enhancement of current systems, processes, and resources, identify and recommend improvements, and ensure timely, effective communication of changes or enhancements</li><li>
Manage multiple projects simultaneously, quickly shift priorities and deliver excellent solutions under tight timelines</li><li>
Perform other job duties as requested</li></ul><div></div><div>
Education and Experience:</div><ul><li>
Bachelor&rsquo;s Degree or equivalent years of relevant work experience in human resources or related discipline is required</li><li>
Minimum of two (2) years of experience in human resources, talent management, organizational development, or related field highly preferred</li><li>
Experience working within the Workday and Qualtrics platforms preferred</li></ul><div></div><div>
Competencies, Knowledge and Skills:</div><ul><li>
Proficient in Microsoft Office including Word, Excel, PowerPoint</li><li>
Demonstrated ability to execute and track project plans and timelines</li><li>
Experience with performance management and experience surveys preferred</li><li>
Demonstrated written, verbal and interpersonal communication skills</li><li>
Strong problem-solving and critical thinking skills</li><li>
Ability to manage multiple priorities and demonstrate self-direction</li><li>
Attention to detail, planning, organization and prioritization skills</li><li>
Strong relationship-building skills</li><li>
Ability to work independently and in a team setting</li><li>
Effective time management skills and strong customer service orientation</li><li>
Ability to maintain confidentiality</li></ul><div></div><div>
Licensure and Certification:</div><ul><li>
Professional in Human Resources (PHR) Certification preferred</li></ul><div></div><div>
Working Conditions:</div><ul><li>
General office environment; may be required to sit or stand for extended periods of time</li></ul><div></div><div>
Compensation Range:</div>
$53,400.00 - $85,600.00<div>
CareSource takes into consideration a combination of a candidate&rsquo;s education, training, and experience as well as the position&rsquo;s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee&rsquo;s total well-being and offer a substantial and comprehensive total rewards package.</div><div></div><div>
Compensation Type (hourly/salary):</div>
Salary<div></div><div>
Organization Level Competencies</div><ul><li><div>
Create an Inclusive Environment</div></li><li><div>
Cultivate Partnerships</div></li><li><div>
Develop Self and Others</div></li><li><div>
Drive Execution</div></li><li><div>
Influence Others</div></li><li><div>
Pursue Personal Excellence</div></li><li><div>
Understand the Business</div></li></ul><div></div><div><br>
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.</div></div>

Job Summary:
The Employee Experience Specialist I is responsible for supporting the implementation of performance and employee experience processes that cultivate a positive, inclusive, employee experience and position CareSource as an employer of choice. This role will work closely with peers across the HR organizational functions to execute priorities and deliverables.
Essential Functions:
Responsible for successful administration of processes supporting the implementation of the CareSource employee experience strategy
Support the execution of the annual performance process, including goal setting, mid-year and year-end reviews with a focus on reviewing and testing system enhancements, updating resources and support tools, reporting and timely responses to questions, and issue resolution
Participate in the buildout, dashboard/data reporting related to candidate, life cycle and employee experience surveys to drive a culture of feedback, development, and inclusion across the organization
Collaborate on the design and implementation of new employee experience process/resource enhancements to streamline an accelerate the integration of new employees into the organization
Support the execution of the Employer of Choice strategy by collaborating on data collection and management needs
Responsible for timely, accurate and effective administration of employee recognition platforms, processes and reporting to support the successful implementation of the overall employee recognition strategy
Develop and maintain project and implementation plans for Employee Experience processes and initiatives on as needed basis
Contribute to the ongoing evaluation and enhancement of current systems, processes, and resources, identify and recommend improvements, and ensure timely, effective communication of changes or enhancements
Manage multiple projects simultaneously, quickly shift priorities and deliver excellent solutions under tight timelines
Perform other job duties as requested
Education and Experience:
Bachelor’s Degree or equivalent years of relevant work experience in human resources or related discipline is required
Minimum of two (2) years of experience in human resources, talent management, organizational development, or related field highly preferred
Experience working within the Workday and Qualtrics platforms preferred
Competencies, Knowledge and Skills:
Proficient in Microsoft Office including Word, Excel, PowerPoint
Demonstrated ability to execute and track project plans and timelines
Experience with performance management and experience surveys preferred
Demonstrated written, verbal and interpersonal communication skills
Strong problem-solving and critical thinking skills
Ability to manage multiple priorities and demonstrate self-direction
Attention to detail, planning, organization and prioritization skills
Strong relationship-building skills
Ability to work independently and in a team setting
Effective time management skills and strong customer service orientation
Ability to maintain confidentiality
Licensure and Certification:
Professional in Human Resources (PHR) Certification preferred
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$53,400.00 - $85,600.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

CareSource

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