Under the direction of the Vice President of Clinical Services, oversee clinical programs to ensure compliance.
- Develop, implement, and oversee clinical programs and their outcomes, including adherence programs, retrospective DUR, Medication Therapy Management, disease specific care mangement, medication reconciliation and other programs as developed.
- Review clinical prior authorizations for therapeutic appropriateness.
- Assist in the development of prior authorization and step therapy criteria.
- Coordinate and assist with employee training and development.
- Answer drug information questions as requested.
- Monitor reports and operational processes to ensure maximum efficiency.
- Respect and maintain confidentiality guidelines of HIPAA.
- Follow and aid in enforcement of all company policies and procedures.
- Responsible for other duties as assigned.
- Periodic consultation with practitioners in the field.
- Consult with account management team to provide clinical and benefit design recommendations.
- Participate in client or account management presentations to explain clinical programs and outcomes.
- Doctor of Pharmacy (Pharm. D)
- Valid Pharmacist License, in good standing (RPh)
- Ability to become licensed in multiple states as required.
- One year minimum as a practicing pharmacist with direct patient care.
- Residency preferred.
- Familiarity with Microsoft Word, Excel, and Outlook.
Environmental/ Working Conditions:
- Attention to detail and accuracy.
- Ability to communicate effectively, patiently and courteously.
- Ability to handle multiple activities or interruptions at once.
- Focused team player, who can work in conjunction with pharmacists, other departments, customers, and management.
- Work independently with little supervision and meet daily deadlines.
This position is in a typical office environment which requires prolonged sitting and standing in front of a computer. In addition, this position requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment, including the operation of standard computer and phone equipment. May have occassional high stress when dealing with customers/clients and employees. This position may be required to work long hours.