Job Description
Work Location: Remote
Assignment Duration: 6 months (Possibility to extend)
Work Schedule: 10am – 6:30pm EST, OT possible
Work Arrangement: Remote
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.
| Education/Certification | Required: Bachelors / PharmD | Preferred: | ||
| Licensure | Required: Current states pharmacist license | Preferred: | ||
| Years of experience required: 1 to 3 years experience Disqualifiers: None Additional qualities to look for: Flexibility to work a weekend rotation | ||||
| 1 | Clinical decision making | ||
| 2 | Ability to learn new skills quickly | |||
| 3 | Adaptability | |||
- For information on benefits, equal opportunity employment, and location-specific applicant notices, click here
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 53.00/daily.