Position Title: Clinical Pharmacist 1
Work Location: Remote
Assignment Duration: 6 months with potential to extend or convert FT
Work Schedule: 10 am – 6:30 pm EST, OT possible
Position Summary:
Define and develop standard and custom formularies for assigned plan.
Background & Context:
This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business.
Key Responsibilities:
Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
Monitor prior authorization requests
Provide clinical support to internal departments and address clinical related questions
Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
Develop and implement programs designed to impact DUR for both Medicaid and Medicare
Develop, implement, and maintain policies and procedures for the pharmacy department
Participate in the coordination of the Medicare MTM program
Assist case management team with members including clinical rounds presentations
Qualification & Experience:
Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy
2+ years of mail order, retail, hospital or managed care pharmacy experience OR 1+ years of pharmacy residency program experience
Current state’s Pharmacist license with no restrictions
Notes:
A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determinations
Candidate Requirements
Education/Certification: Required: Bachelors / PharmD
Licensure: Required: Current state’s pharmacist license