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Job Summary

The Clinical Pharmacist will report to and operate under the direction of Pharmacy Leadership and will also be expected to work cooperatively and sometimes independently with all medical directors and enterprise personnel.

Requirements

EDUCATION

Bachelor's degree in Pharmacy from an accredited college of pharmacy

LICENSING/CERTIFICATION

Holds an active and current, unrestricted license in pharmacy in the state(s) where job duties are performed required

EXPERIENCE

Minimum three (3) years' pharmacy practice experience

Minimum three (3) years' experience in managed pharmacy care and drug utilization review preferred

This position may require up to or around 24 hours a week.

ESSENTIAL SKILLS & ABILITIES

Oral & Written Communication

Presentation

Organizational

Analytical

Problem-Solving

Decision-Making

Skills

• Coaching Others • Conflict Resolution • Continuous Learning • Critical Thinking • Delegating Tasks • Employee Engagement Strategies • Evaluating Information • Interpersonal Communication • Interpersonal Relationships • Management Techniques • Monitor Processes, Materials, or Surroundings • Oral Communications • Problem Sensitivity • Researching • Service Oriented • Time Management • Written Communication

Responsibilities

• Assists in development of and supervises the drug utilization and prior authorization review program • Contributes to and supports Enterprise-wide undertakings and commitments • Develops, implementks, and manages pharmacy cost containment strategies • Develops and implements pharmacy cost containment strategies tailored to the specific situations and patterns of the enterprise, specific regions, and large accounts • Drafts medical criteria and performs other activities in support of the enterprise prior authorization program • Prepares and presents reports, data and analyses on the utilization and cost trends for enterprise lines of business, specific regions, and large accounts • Provides leadership and advice on developing and implementing pharmacy reimbursement, claims processing policies and procedures, and pharmacy vendor selection • Serves as a corporate pharmacy resource to medical management, operations, and sales staffs on pharmacy issues • Serves as a liaison to individual pharmacists, professional pharmacy organizations, internal committees, case management, medical management, and other providers on pharmacy issues • Uses clinical knowledge and independent critical thinking skills towards interpreting criteria, policies, and procedures to make determinations on prior approval reviews and retrospective reviews • Works with the clinical and operations staff of all vendors of pharmacy programs to ensure that members and providers are receiving a satisfactory-level of service

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.