Medical Policy Pharmacist
3 weeks ago
Job Summary
As a Medical Policy Pharmacist at Optum, you will play a critical role in ensuring the safe and effective use of specialty pharmaceuticals. You will be responsible for dispensing unit doses, specialty pharmaceuticals, injectables, IV, enteral, and related supplies, following state and federal regulations and company policies and procedures.
Key Responsibilities
- Process, pack, and ship outgoing pharmacy orders, ensuring drug, related supplies, and patient collateral (education materials) are included.
- Perform drug/supply ordering and inventory/warehouse duties, including proper storage of drugs and supplies and appropriate refrigeration of perishable product, monitor and adjust/calibrate pharmacy equipment, fill dispensing units.
- Review medication orders and evaluate the appropriateness and completeness of orders with consideration given to the special needs and behaviors of the specific age group served.
- Provide oversight of the safety, appropriateness, and effectiveness of the pharmaceutical care provided to patients (consumers) as it relates to specialty products dispensed.
- Assess the patient at the initiation of drug therapy, develop a patient care plan and drug monitoring regimen, and monitor the patient according to the care plan throughout the course of therapy.
- Communicate with the patient, physician, nursing staff, other pharmacists, and other members of the health care team regarding patient status, response to therapy, and clinical objectives to ensure clinical outcomes are met.
- When required, compound intravenous and specialty pharmaceuticals in an aseptic fashion according to established State Board of Pharmacy, Federal, USP797 sterile guidelines and company policy.
- Ensure compliance with all FDA, DEA, State Board of Pharmacy, OSHA, and other regulatory standards; Follows all department policies and procedures.
- Provide indirect oversight of pharmacy technician and pharmacy support staff.
- Interpret provider prescription and create order, access, input, and retrieve prescription and medical/lab information from computer system, verifies whether order/drug is reimbursable/covered.
- Contact members/patients to validate data, resolve rejected claims, request payment information, establish priority of order or delivery details, consult on medication issues, and set up treatment in on-site facilities.
- Prep and scan documents, verify member/patient data, submit prescription orders in computer system.
Requirements
- BS in Pharmacy or PharmD degree.
- Solid drug product and clinical pharmacy knowledge.
- Proficient with Microsoft Office.
- Ability to work a flexible schedule (8-hour shifts between hours of 7am-7pm weekdays with rotating weekends) and rotate being on call based on business needs.
- Permanent residence within a commutable distance to the branch.
- Pharmacist with Home Care or Home Infusion experience.
- CPR+ software experience.
- Sitting, standing, walking in an office/pharmacy operation environment.
About Optum
At Optum, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
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