Clinical Pharmacist

4 days ago

Oklahoma City, Oklahoma, United States National Health Care Solutions Full time
About the Role

We are seeking a highly skilled Clinical Pharmacist to join our team at National Health Care Solutions. As a Clinical Pharmacist - Prior Authorization Specialist, you will play a critical role in ensuring the accuracy and efficiency of our prior authorization process.

Key Responsibilities
  • Document Review and Management: Review, create, and maintain various documents and reports used internally and externally to ensure accuracy and compliance.
  • Criteria Updates and Software Implementation: Review quarterly criteria updates and implement PA software applications to ensure seamless integration.
  • Quality Control and Criteria Management: Perform various duties to successfully fulfill the function of the position, including prior authorization reviews, quality control, and criteria management.
  • Production, Quality, Attendance, and Adherence Standards: Meet and/or exceed production, quality, attendance, and adherence standards to ensure exceptional performance.
  • Training and Development: Provide and assist in training other employees to ensure knowledge sharing and skill development.
Requirements
  • Education: Pharm.D. degree from an accredited university.
  • Clinical Background: Strong clinical background in PBM, managed care, or clinic practice settings (three years).
  • Drug Utilization Management: Excellent knowledge of all aspects of drug utilization management processes, including coverage policies, prior authorizations, and communication of drug utilization management program updates.
  • Critical Literature Evaluation: Proficient in critical literature evaluation skills, including evidence-based medicine principles.
  • Active Pharmacy Licensure: Active pharmacy licensure with no restrictions, in the state(s) of licensure.
  • MediSpan Data System: Strong knowledge of MediSpan data system, including GPI drug classification system.
  • Drug Literature and Clinical Trials: Proficiency in drug literature, clinical trials, and national guidelines.
  • Prescription Benefits Claims Processing: Familiarity with prescription benefits claims processing and formulary design.
  • Communication and Organizational Skills: Excellent verbal and written communication skills, as well as excellent organizational and time management skills.
  • Dependability and Analytical Skills: Demonstrate dependability through good attendance and adherence to timelines and schedules, and possess excellent analytical skills.
  • Customer Service Orientation: Strong customer service orientation and commitment to professionalism.
  • PC Applications: Strong proficiency in PC applications, including Microsoft Office.
  • Teamwork and Problem-Solving: Demonstrated ability to work collaboratively in a team environment and possess excellent interpersonal and problem-solving skills.

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