Pharmacist - Health Plan Specialist

2 weeks ago


Albany, California, United States TotalMed Staffing Full time
About this Role

As a Pharmacist, you play a vital role in promoting safe, effective, and cost-efficient 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, monitoring medication patterns and identifying potential misuse or overuse.
• 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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