Clinical Pharmacist PBM

Employer
A Line Staffing Solutions
Location
Getzville, New York, US
Closing date
Oct 19, 2021

View more

Position Type
Clinical Pharmacist
Specialty Area
Other
Work Setting
Other
Top Health Plan / Managed Care company, is currently seeking a Clinical Pharmacist based out of the Getzville, NY 14068 office. Please apply directly to this posting for consideration.

** This position is WFH (REMOTE) until at least September**

Pay Rate: $50.00 to $55.00 per hour (determined on experience)

Shift Time: Monday - Friday from 8:30am-5pm EST

Job Duties:
  • Develop clinical criteria for review of medications, recommend plan design changes and communicate recommendations to clients
  • Monitor and review prior authorization requests for medications
  • Develop and design clinical edits to adjudicate claims and enhance drug utilization
  • Analyze pharmacy cost of care, trends, and coordinate the development of appropriate use protocols and guidelines
  • Set criteria for medication analysis, coordinate reports to clients, meet regulatory reporting requirements for drug utilization review and fraud and abuse reporting
  • Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews
  • Participate in the development and implementation of medication therapy management programs
  • Provide clinical guidance and support to various departments and address clinical related questions.


Required Skills:
  • Must be an actively Licensed RPh in New York in good standing
  • Must have either a Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree
  • 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.

Preferred Skills:
  • Experience in a Managed Care Pharmacy Setting
  • Experience with CVS/Health PBM Systems: RxClaim, CAS, MedHOK
  • Be familiar with Centers for Medicare and Medicaid (CMS) regulations and guidelines
  • Tru Care Experience
  • Medication Therapy Management MTM/CMR experience (preferred not required)


Why Apply:
  • Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
  • 401k after 1 year of employment: With employer match and profit sharing
  • GREAT Hours! Monday through Friday
  • Competitive Pay Rate!


Keywords: RPh, PBM, Pharmacy Benefit Management, RxClaim, CAS, MedHOK, CMR, Clinical Research, Clinical Pharmacy, Dispensing, Compounding, Registered Pharmacist, DUR, Drug Utilization Review, Infusion, MTM, Medication Therapy Management, BPharm, Licensed Pharmacist, PharmD, Prior Authorization, Pharmacy, Pharmaceutical, Mail Order Pharmacy, Prescriptions, Rx, Medication, Clinical Pharmacist, Staff Pharmacist, RPh, PBM, Pharmacy Benefit Management, RxClaim, CAS, MedHOK, CMR, Clinical Research, Clinical Pharmacy, Dispensing, Compounding, Registered Pharmacist, DUR, Drug Utilization Review, Infusion, MTM, Medication Therapy Management, BPharm, Licensed Pharmacist, PharmD, Prior Authorization, Pharmacy, Pharmaceutical, Mail Order Pharmacy, Prescriptions, Rx, Medication, Clinical Pharmacist, Staff Pharmacist.

Job Requirements:

Required Skills:
  • Must be an actively Licensed RPh in New York in good standing
  • Must have either a Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree
  • 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.

Preferred Skills:
  • Experience in a Managed Care Pharmacy Setting
  • Experience with CVS/Health PBM Systems: RxClaim, CAS, MedHOK
  • Be familiar with Centers for Medicare and Medicaid (CMS) regulations and guidelines
  • Tru Care Experience
  • Medication Therapy Management MTM/CMR experience (preferred not required)


Keywords: RPh, PBM, Pharmacy Benefit Management, RxClaim, CAS, MedHOK, CMR, Clinical Research, Clinical Pharmacy, Dispensing, Compounding, Registered Pharmacist, DUR, Drug Utilization Review, Infusion, MTM, Medication Therapy Management, BPharm, Licensed Pharmacist, PharmD, Prior Authorization, Pharmacy, Pharmaceutical, Mail Order Pharmacy, Prescriptions, Rx, Medication, Clinical Pharmacist, Staff Pharmacist, RPh, PBM, Pharmacy Benefit Management, RxClaim, CAS, MedHOK, CMR, Clinical Research, Clinical Pharmacy, Dispensing, Compounding, Registered Pharmacist, DUR, Drug Utilization Review, Infusion, MTM, Medication Therapy Management, BPharm, Licensed Pharmacist, PharmD, Prior Authorization, Pharmacy, Pharmaceutical, Mail Order Pharmacy, Prescriptions, Rx, Medication, Clinical Pharmacist, Staff Pharmacist.

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