Job Description

Job Description

CLIENT OVERVIEW:

Our client is a major PBM (Pharmacy Benefit Services) entity owned by 20 non-profit health plans serving >33 million members and benefits manager of government programs including Medicare and Medicaid.

JOB OVERVIEW:

Position: Pharmacist (CA State Licensure)

Location: Work from home, Candidate must be in California

Duration: 6 months contract with a possibility of extension

Note: Must have hard-wired internet and safe working space.

SUMMARY:

• Performs prospective and/or retrospective drug utilization review and appeals per State and Federal regulations.
• Participates in the distribution of clinical drug information and educates providers and staff regarding the use of pharmaceutical treatment regimens.
• Complies with all corporate and facility standard operating procedures, policies, guidelines, and work instructions.

JOB RESPONSIBILITIES:

• Provides prior authorization services for formulary drugs, develops programs to provide optimal pharmacy care to patients, participates in drug utilization review programs, reviews assessment and documentation of patient care, and retrospective reviews of provider reimbursement.
• Makes recommendations to physicians and other prescribers on medication regimens as per plan guidelines.
• Assists providers to ensure accurate dispensing and billing of products.
• Collaborates with other clinical personnel in assessing treatment guidelines.
• May participate in formulary development and management.
• Supports the National Pharmacy and Therapeutics Committee.
• Validates the clinical availability of multi-source products for provider utilization.
• Adheres to organizational policies and procedures.
• Ensures compliance with Federal and State laws and standards of practice which govern the profession of pharmacy.
• Maintains pharmacy records by all applicable state and federal laws and regulations.
• Maintains clinical skills and knowledge of pharmacotherapy by reviewing the literature, continuing education, and any company-provided in-services.
• Completes all mandatory company-provided online courses.
• Attends and completes all employee development courses.
• Participates in the mandatory on-call rotation when required by business needs.
• Makes outbound or takes inbound telephone calls to assist in various aspects of patient care and/or product distribution to/from practitioners, members, and pharmacies.
• These calls include, but are not limited to, comprehensive medication reviews, targeted medication reviews, calls to practitioners about product awareness, and prior authorizations.

JOB REQUIREMENTS:

• Strong drug product and clinical pharmacy knowledge.
• The license must be current and in good standing.
• Education/Certifications: Rph or PharmD, Doctor Of Pharmacy, CA State Licensure – Pharmacy

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