Pharmacist - Health Plan Specialist

3 days ago


New York, New York, United States TotalMed Staffing Full time
About the Role

We are seeking a skilled Pharmacist to join our team as a Health Plan Specialist. In this role, you will play a vital part in promoting safe and effective medication use while supporting the overall goals of the health plan in improving member health outcomes.

Key Responsibilities
  • Conduct activities to ensure safe and cost-effective medication use, including monitoring medication patterns and implementing interventions as needed.
  • Participate in quality improvement initiatives aimed at enhancing medication-related outcomes, such as medication adherence and safety.
  • Educate healthcare providers within the network about the health plan's formulary, coverage policies, and medication-related initiatives to ensure alignment with best practices and optimize patient care.
  • Review medication requests that require prior authorization to ensure they meet clinical criteria for coverage.
  • Develop and manage the formulary, which is the list of medications covered by the health plan.
Requirements
  • Active Registered Pharmacist License
  • 2 years of experience as a Pharmacist
  • 1 year within a Managed Care setting


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