Job Description

Job Title: Pharmacist 1

Duration: 6 months with possible extension

Location: 100% remote-

Shift: M-F 10am 6:30pm EST, OT possible (40.00 Hours a week) (Flexibility to work a weekend rotation)

Pay rate range: $58 to 67/hr .

Job Summary

• Define and develop standard and custom formularies for assigned plan.
• This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business.
• A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determinations

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

Requirements

• 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.

Skills

• Clinical decision making
• Ability to learn new skills quickly
• Adaptability

Job Tags

Similar Jobs