Case Management, Clinical Support, Medicaid, Medicare, Medications, Performance Management, Pharmacy, Policy Implementation, Quality Assurance
Summary:
- Work Mode: 100% Remote in USA
- Duration: 6 months, possible extension and/or conversion
- Shift: 10am – 6:30pm EST, OT possible
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 initiate 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
Requirements:
- Education/Certification: Required: Bachelors / PharmD
- Licensure: Required: Current state's pharmacist license
- Years of experience required: Minimum 1 year of experience
Preferred Skills:
- Flexibility to work a weekend rotation
- Top 3 must-have hard skills stack-ranked by importance:
- Clinical decision making
- Ability to learn new skills quickly
- Adaptability
A
Axelon Services Corporation