Clinical Pharmacist 1

Position Summary:

Define and develop standard and custom formularies for assigned plan.

Background & Context:

This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business.

Key Responsibilities:

* Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated

* Monitor prior authorization requests

* Provide clinical support to internal departments and address clinical related questions

* Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice

* Develop and implement programs designed to impact DUR for both Medicaid and Medicare

* Develop, implement, and maintain policies and procedures for the pharmacy department

* Participate in the coordination of the Medicare MTM program

* Assist case management team with members including clinical rounds presentations

Qualification & Experience:

* Bachelor's degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.

* Current state's Pharmacist license with no restrictions.