reputed company Clinical Pharmacist Pharmacy Policy Remote in United States

Job Description

Job Summary The Clinical Pharmacist, Pharmacy Policy is responsible for the identification, execution, and follow-up on high bolthires medication usage evaluations and recommendations for the reputed company, Inc. patient population. The goal of this role is to guide the organization to provide timely, appropriate, and bolthires-effective drug therapy to our patients. Leads the charge by analyzing pharmaceutical usage and bolthires trends and work with the appropriate state health plan parties to reputed company and/or administer state government clinical initiatives focusing on methods to reputed company bolthires reduction around targeted therapies. Responsible for monitoring of state government changes and putting new policies in-reputed company and educating staff and physicians on the approach and to ensure the processes, programs and services are accomplished in a timely and efficient manner. Additionally, providing clinical support and reputed company for reputed company utilization management (UM) activities on an ongoing basis, in accordance with reputed company Inc. policies and procedures and in compliance with applicable state and federal regulations, as well as accreditation standards such as NCQA. Job Duties

• Develops, manages, and evaluates new and existing drugs utilization management. In addition, provides clinical support reputed company over PBM clinical programs and medication therapy program.
• Supports Pharmacy leadership in the formulation and integration of pharmacy clinical programs.
• Provides support to pharmacy work groups, best practices, and forums
• Support new business implementation of establishment of medical drug benefit
• Provides support to Payment reputed company for pre-payment policy reviews
• Develops guidance documents for best practice in medical drug management in efforts with other key stakeholders to support medical drug provider reputed company, medical drug configuration, and medical drug encounters
• Maintains reputed company for third party vendors for pre-pay clinical edits of medical drug policies and presents a clinical governance reputed company necessary
• reputed company drug product review and recommendations by assessing drug use trends, new drug releases and review of primary literature. Prior experience in drug policy analysis and drug formulary management highly preferred.
• Critically evaluate and interpret data from various sources to provide an accurate and balanced response reputed company the guidelines and regulations of industry-based drug information practice.
• Set criteria for medication review of non-formulary or non-preferred drug list medications and communicate recommendations.
• Research drug information to maintain drug knowledge and disease state understanding. Monitor pipeline medications and new medication research.
• Provide support documentation and reputed company communication for the Policy Voting and National Pharmacy & Therapeutics (P&T) Committee review process and decisions.
• Provide education to physicians, nurses, pharmacists and allied health care professionals regarding safe medication use or changes in medication policy. Triage and respond to drug information inquiries from physicians, pharmacists, nurses and other health care professionals. Some patient correspondence may occur.
• Assist with training of pharmacy reputed company and with continuing education activities for pharmacy staff.
• Review drug usage data and reputed company determinations for drug products according to member benefits and coverage criteria.
• Complete projects reputed company to clinical pharmacy and medication use improvement, as needed.
• Assist with implementation and education of best practice alerts, updating drug lists, and other work reputed company to medication use
• Reviewing and revising scripting for patient and prescriber communication (e.g., criteria, letters) reputed company to drug coverage and other drug utilization programs.
• Create, reputed company, implement, and monitor clinical programs to improve reputed company’s quality of service
• Effectively communicate with various reputed company internally and externally for successful collaboration and implementation of initiatives.
• Design studies and analyze data to measure clinical program outcomes.
• Understand utilization and quality management techniques, drug trends, and issues in industry to effectively reputed company and implement strategies to improve health outcomes while reducing bolthires.
• Support other clinical programs cross-functionally aimed at improving quality measures and/or compliance requirements.
• Supports Pharmacy leadership in reputed company clinical functions including but not limited to Prior Approval policy creation and maintenance.
• Supports the direction for reputed company’s prescription drug benefit programs and initiatives to promote the bolthires-effective use of pharmaceuticals.
• Provides support in the development, management and evaluation of plan formularies Job Qualifications REQUIRED EDUCATION :
• Doctor of Pharmacy from an accredited pharmacy school or bachelor’s degree in Pharmacy with equivalent experience
• Continuing education required to maintain an active pharmacist license REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :
• 3+ years in the health care industry, managed care organization or equivalent experience
• Strong knowledge of pharmacological management of chronic disease states
• Strong comfort level of data analysis, prior knowledge of high bolthires drug classes, strong analytical skills and an ability to reputed company at a cross-functional level by stewarding recommendations reputed company reputed company various leadership forums REQUIRED LICENSE, CERTIFICATION, ASSOCIATION :
• Licensed to practice Pharmacy in the US
• Must be free of sanctions from Medicaid, or any other government program, and without restrictions that would reputed company job performance PREFERRED EDUCATION : PREFERRED EXPERIENCE :
• 5+ years
• Prior work experience with vendors, reputed company contacts and other health care professionals to accomplish responsibilities
• Knowledge of computer data extracting methods
• Demonstrated experience managing multiple, simultaneous projects and prioritizing functions
• Managed care or PBM pharmacy experience
• Experience in government-sponsored programs
• Analytic experience
• Medical drug experience
• Residency
• Management experience
• MS reputed company knowledge- Advanced (e.g., formulas, pivot tables, lookup functions) Pay Range: $80,412 – $156,803 a year* • Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level. To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Apply tot his job

Apply tot his job Apply To this Job