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Clinical Pharmacist

3 months ago

Pine Brook, United States ALLMED Staffing Full time

Large managed care company looking to fill a contract Clinical Pharmacist role.

Work hours: 9 AM - 5 PM

Work location: telecommuter

Description:

• Provide clinical guidance in the creation, implementation and refinement of a Specialty utilization management solution

• Serve as a subject matter expert in evidence-based guidelines and help ensure all clinical relevant policies and processes are informed by the best available evidence

• Research upcoming drug releases and treatment guidelines, develop and maintain pharmacy programs, such as formulary lists, drug utilization review, prior authorization, health outcomes, disease state management, care management, and other specialty programs. May also include presenting at Pharmacy & Therapeutics Committee

• Interpret pharmacy programs to write clinical guidelines, job aides, and decision trees. Write and collaborate on member/provider collateral materials for pharmacy programs

• Work on program implementation teams and contribute to business process design and systems set up & updates

• Support utilization review determinations for specialty populations, and broader case and disease management teams to achieve optimal clinical outcomes

• Evaluate clinical and other data (e.g., quality metrics, claims & health record data, utilization data) to identify opportunities for improvement of clinical care and processes

Preferred Qualifications:



• Pharmacist with PharmBS or PharmD

• 5+ years clinical pharmacy experience

• 2+ years’ experience administering and/or advising onspecialty treatment plans (utilizing/reviewing medical case notes, medication list, lab results etc.)
• 2+ years’ experience in managed care, medical care delivery systems, utilization management, case management, disease management, quality management, product development and/or peer review
• Experience working with evidence-based medicine
• Experience working prior authorization processes
• Strong working knowledge of various specialty conditions
• Ability to work cross-functionally to gain credibility, influence and partner with other specialty professionals