Job Profile Summary Position Purpose: Define and develop standard and custom formularies for assigned plan. Education/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. Licenses/Certifications: Current state s Pharmacist license with no restrictions. 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 | ||||||
| Story Behind the Need | ||||||
| We provide medication reviews for members that have qualified for one of our pharmacy clinical programs. Currently we have a clinical program expanding and need additional support temporarily. No further hiring needs. | |||||
| Typical Day in the Role | ||||||
| Pharmacist will be expected to review a patient s medical information and pharmacy claims for gaps in care, drug therapy problems, etc. Expectation is 90% productivity daily. | |||||
| Candidate Requirements | ||||||
| Education/Certification | Required: B.S. in Pharmacy or PharmD | Preferred: | ||||
| Licensure | Required: required to be licensed in state of residence | Preferred: | ||||
| Years of experience required: at least 2 years pharmacy experience Disqualifiers: NA Additional qualities to look for:NA | ||||||
| 1 | Work independently | ||||
| 2 | Critical thinking | |||||
| 3 | Clinical skill | |||||
| Candidate Review & Selection | ||||||
| Projected Manager Candidate Review Date: | 1-2 days post shortlisting | ||||
Type of Interviews: | Teams | |||||
| Required Testing or Assessment (by Vendor): | na | |||||
| Next Steps | ||||||
| No | |||||
| None | |||||
| Compliance Questions | ||||||
| No | |||||