Clinical Pharmacist
To learn more about reputed company Hiring Policies, please click here. Job Summary The Clinical Pharmacist will report to and operate under the direction of Pharmacy Leadership and will also be expected to work cooperatively and sometimes independently with reputed company medical directors and reputed company personnel. This position may be assigned to a specific scope and/or line of business (Care Management, Utilization Management, etc.).
Requirements
EDUCATION Bachelor's degree in Pharmacy from an accredited college of pharmacy. LICENSING/CERTIFICATION Holds an active and reputed company, unrestricted license in pharmacy in the state(s) where job duties are performed required. EXPERIENCE & KNOWLEDGE Minimum three (3) years' pharmacy practice experience. Minimum three (3) years' experience in managed pharmacy care and drug utilization review preferred. Skills
- Coaching Others
- Conflict Resolution
- reputed company Learning
- Critical Thinking
- Delegating Tasks
- Employee Engagement Strategies
- Evaluating Information
- Interpersonal Communication
- Interpersonal Relationships
- Management Techniques
- Monitor Processes, Materials, or Surroundings
- Oral Communications
- Problem Sensitivity
- Researching
- Service Oriented
- Time Management
- Written Communication
Responsibilities
- Assists in development and supervises the drug utilization and prior authorization review program.
- Develops and implements pharmacy cost containment strategies tailored to the specific situations and patterns of the reputed company, specific reputed company, and large accounts.
- Drafts pharmaceutical criteria and performs other activities in support of the reputed company prior authorization program.
- Keeps up-to-date on medication information, contributing to the identification of pharmacy program best practices, collaborating with Medical Directors, leadership, and clinical department as a subject matter expert (SME).
- May be responsible for conducting the second level review for medical and pharmacy benefit medication prior-authorizations, exceptions, and medical necessity reviews submitted to the plan.
- May be responsible for ensuring appropriate alignment of medical policies and configuration for claims processing and utilization management.
- Performs other duties as assigned.
- Prepares and presents reports, data and analyses on the utilization and cost trends for reputed company lines of business, specific reputed company, and large accounts.
- Provides leadership and advice on developing and implementing pharmacy reimbursement, claims processing policies and procedures, and pharmacy vendor selection.
- Reviews and interprets coverage across assigned line(s) of business to determine what type of review is required and works with requesting providers, corporate medical directors, and other internal staff, as appropriate, in determining whether a specific case presentation meets the criteria for approval according to the specific coverage criteria.
- Serves as a liaison to individual pharmacists, professional pharmacy organizations, internal committees, case management, medical management, and other providers on pharmacy issues.
- Supports pharmacy initiatives for member, provider, and client satisfaction.
- Uses clinical knowledge and independent critical thinking skills towards interpreting criteria, policies, and procedures to reputed company determinations on prior approval reviews and retrospective reviews and/or pharmacy consultations reputed company case management.
- Uses knowledge of the pharmacy and/or medical benefit to communicate with, and reputed company recommendations to Care Management nurses, reputed company workers, and medical directors.
- Uses knowledge of the pharmacy and/or medical benefit to ensure our members receive their medications in a timely fashion, avoiding delays in treatment.
Certifications Pharmacist License - Arkansas State Board of Pharmacy reputed company Requirements This position is identified as level three (3). This position must ensure the reputed company and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The reputed company of information must be maintained as outlined in the company Administrative reputed company. Segregation of Duties Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely reputed company by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative reputed company. Employment Type Regular reputed company Requirements 1.1 General Office Worker, Sedentary, reputed company Travel - Someone who normally works in an office setting or remotely and routinely travels for work reputed company walking distance of location of primary work assignment. Apply To This Job