Pharmacist
Job Title: Pharmacist 1
Duration: 6 months (Possible Extension)
Location: Remote
Shift: Day 5x8-Hour (08:00AM - 05:00PM)
Job Summary
Position Purpose:
Duration: 6 months (Possible Extension)
Location: Remote
Shift: Day 5x8-Hour (08:00AM - 05:00PM)
Job Summary
- The main function of a pharmacist is to dispense prescription medications to patients and offer expertise in the safe use of prescriptions.
- They also may conduct health and wellness screenings, provide immunizations, oversee the medications given to patients, and provide advice on healthy lifestyles.
Position Purpose:
- Provide timely drug therapy for Medicaid health plan members by processing prior authorization and medical necessity requests
- Direct resources to individual cases, projects, or critical needs.
- Update health plan pharmacy documentation in conjunction with state laws.
- Maintain relationships with all health plan pharmacy leadership regarding escalated claims
- Implement, maintain and provide training on all departmental process and procedural documents, including prior authorizations
- Manage prior authorization requests and pharmacists’ determinations for drug products according to member benefits and coverage criteria
- Provide clinical guidance and support to the assigned pharmacists and pharmacy technicians
- Responsible for setting criteria for medication analysis, coordinate reports to clients, meet regulatory reporting requirements for drug utilization review and fraud and abuse reporting
- Develop clinical criteria for review of non-formulary or non-preferred drug lists medications and communicate recommendations to clients
- Oversee the drug utilization review and medication therapy management programs at the assigned plan to meet Medicare Part D requirements and develop systematic reviews of prescription claims to meet strategic initiatives
- Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practices
- Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews
- Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy. 3+ years of retail or hospital pharmacy experience or 1+ years of managed care pharmacy experience. Clinical pharmacy experience in managed healthcare preferred.
- Current state’s Pharmacist license with no restrictions. An additional license may be required as needed by state or contract.
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Seniority level
Mid-Senior level -
Employment type
Contract -
Job function
Health Care Provider -
Industries
Staffing and Recruiting
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