Clinical Pharmacist

2 days ago

Minneapolis, United States Pride Health Full time
Job DescriptionJob Description

Pride Health is hiring for a Clinical Pharmacist (Remote Contract)

Schedule: Monday-Friday, 8am-5pm, rotating weekends
Contract: 7 month contract
Pay Rate: $70-77/hour

Primary Responsibilities:
  • Interpret physicians' prescriptions and clinical documentation, accesses clinical criteria and compendia support
  • Consult with customers, patients and/or physicians regarding use of medications, potential drug interactions, and clinical status for appeals requests
  • Conduct Quality Assurance and verify the accuracy of all prescriptions to render appeal decision
  • Provide explanations and interpretations within area of expertise
  • Review formulary and utilization management guidelines to determine if the drug should be a covered benefit for the beneficiary based on their medical history
  • Research, evaluate, and make determinations on member and provider appeals of pharmacy coverage decisions
  • Gather complex clinical information, consider approved compendia, medical literature, coverage policy, and criteria information and work within regulatory guidelines to render decisions. Decision may require consulting with Plan Medical Directors and the beneficiaries treating physician.
  • Answer questions from support personnel regarding prescription drugs
  • Position requires excellent record keeping skills, thorough documentation, clear and concise written/verbal communications skills

Required Qualifications:
  • Active and unrestricted Pharmacist license
  • PBM experience
  • Pharm D
  • Experience in Medicaid, Commercial (private), and/or Medicare Part D prescription drug plans, programs or formularies
  • Experience in Coverage Determinations (prior authorization) or member appeals
  • Pharmacy reimbursement (third party insurance, Medicare Part D formulary management, Medicaid)

Apply with Pride Health for this opportunity

#CB #LI-JC1

Company DescriptionPride Health is a leading minority-owned healthcare recruitment & staffing firm that offers highly customized business process solutions at cost-effective prices.

Headquartered in New York City as a top minority supplier, PRIDE Health offers a broad geographic reach with offices throughout the U.S., India, and Brazil. Leveraging more than 20 years of experience, PRIDE has enhanced its core competency of IT staffing services by creating client-centric, cost-effective IT, and business process solutions. PRIDE serves Client-Partners in the healthcare, IT, financial services, retail and insurance industries offering both Direct Hire and Temporary Staff of Healthcare Professionals, Vendor Management Systems, IT Hardware Procurement Services, and Business Processing Outsourcing.

Temporary, Contract, Per Diem & Direct Hire staffing solutions are only part of what we can offer our clients.Company DescriptionPride Health is a leading minority-owned healthcare recruitment & staffing firm that offers highly customized business process solutions at cost-effective prices.\r
\r
Headquartered in New York City as a top minority supplier, PRIDE Health offers a broad geographic reach with offices throughout the U.S., India, and Brazil. Leveraging more than 20 years of experience, PRIDE has enhanced its core competency of IT staffing services by creating client-centric, cost-effective IT, and business process solutions. PRIDE serves Client-Partners in the healthcare, IT, financial services, retail and insurance industries offering both Direct Hire and Temporary Staff of Healthcare Professionals, Vendor Management Systems, IT Hardware Procurement Services, and Business Processing Outsourcing.\r
\r
Temporary, Contract, Per Diem & Direct Hire staffing solutions are only part of what we can offer our clients.

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