Pharmacist - Pharmaceutical Systems and Policy - School of Pharmacy

2 weeks ago

Morgantown, United States West Virginia University Research Corporation Human Resources Full time

The Department of Pharmaceutical Systems and Policy in the School of Pharmacy at West Virginia University Research Corporation is currently accepting applications for a Pharmacist at Rational Drug Therapy Program.

About the Opportunity

As a Pharmacist at Rational Drug Therapy Program, you will be responsible for conducting clinical reviews of prior authorization requests, performing concurrent drug utilization review with program instructions, and providing general pharmacy information using the point-of-sale computer system established by the West Virginia Bureau of Medical Services (WVBMS) and the current point-of-sale computer system utilized by the PEIA program. Through this role, you will assist in carrying out Rational Drug Therapy Program's mission to ensure WV Medicaid, WV PEIA, and CHIP members receive safe, rational, cost effective, and patient outcome-oriented drug therapy. In this role, you will additionally be performing reviews of prior authorization requests for the Peak Healthcare program in the computer system utilized by that program.

At WVU Research Corporation, we strongly believe in work-life balance and keeping time for things we love outside our work. WVU Research Corporation offers a comprehensive benefits package with a variety of options to suit your needs:

* 13 paid holidays (staff holiday calendar)
* PTO
* 403(b) retirement savings with a fully vested 3% employee contribution match, (Employees have the option of contributing an additional 1-3% of their earnings to the plan, which is also matched by the WVURC)
* A range of health insurance and other benefits
* Dependent Education Scholarship
* WVU Perks
* And More

What you'll do:

* Provide professional services to the WVBMS which include but are not limited to:
* Prior authorization clinical reviews.
* Evaluations of appropriateness of therapeutic duplications.
* Recommendations of appropriate formulary alternatives.
* Conduct reviews of home infusion therapy requests.
* Literature reviews applicable to prior authorization requests.
* Clinically evaluate the appropriateness of various infectious disease drug therapy regimens.
* Evaluate the clinical appropriateness of drug therapy approval with newly marketed medications as allowed by the program.
* Evaluate claims for accuracy of billing.


* Review individual prior authorization, drug utilization review, and billing inquiries and use clinical decision-making skills and therapeutic judgment to determine if claim payment can be approved.
* Acquire and maintain clinical knowledge and information on various disease states in which the program is involved via current, evidenced-based recommendations.
* Review inquiries from technical employees of the program and ascertain the clinical appropriateness of the outcome in comparison to the drug utilization evaluation against which the inquiry is being presented.
* Respond to inquiries in a friendly, professional manner.
* Assist in the orientation and training of all new professional and non-professional personnel.
* Weekend staffing of the program on a rotating basis (approximately every 7-10 weeks depending on staffing needs).
* Bachelor's degree in pharmacy or Doctor of Pharmacy Degree.
* A minimum of one (1) year of retail or hospital pharmacy experience.
* Demonstrated ability to make valid clinical judgments concerning a patient's drug therapy needs, given the guidelines of the program.
* Demonstrated excellent verbal and written communication skills.
* Demonstrated ability to work as a team player and make constructive suggestions to appropriate peers and supervisors.
* Exhibits excellent customer service skills and orientation.
* Exhibits excellent skills in handling difficult persons.
* Demonstrates knowledge of appropriate drug use in most common disease states.
* Exhibits a strong understanding of retail pharmacy operations and insurance billing processes associated with retail pharmacy operations.
* Demonstrated excellent computer data entry, software (Windows based), and typing skills.
* Ability to follow guidelines and convey information in an accurate manner.
* Exhibits the flexibility and the ability to work with different insurance plans and different guidelines.
* Demonstrates the ability to perform duties in compliance with WVU HIPAA and patient confidentiality requirements.
* Ability to maintain proper unit attendance and punctuality standards.

Preferred Qualifications:

* Clinical pharmacy practice.

Certifications:

* Licensed/Registered Pharmacist in WV or Eligible for Licensure/Registration in WV.

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