Clinical - Pharmacist 1

Immediate need for a talented Clinical - Pharmacist 1. This is a 03+ months contract opportunity with long-term potential and is located in TX(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-71390

Pay Range: $60 - $65/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• The main function of a pharmacist is to dispense prescription medications to patients and offer expertise in the safe use of prescriptions.
• They also may conduct health and wellness screenings, provide immunizations, oversee the medications given to patients, and provide advice on healthy lifestyles.
• Responsibilities: Prepares medications by reviewing and interpreting physician orders; detecting therapeutic incompatibilities.
• Dispenses medications by compounding, packaging, and labeling pharmaceuticals.
• Controls medications by monitoring drug therapies; advising interventions.
• Completes pharmacy operational requirements by organizing and directing technicians' work flow; verifying their preparation and labeling of pharmaceuticals; verifying order entries, charges, and inspections.
• Provides pharmacological information by answering questions and requests of health care professionals;
• counseling patients on drug therapies. Develops hospital staff's pharmacological knowledge by participating in clinical programs; training pharmacy staff, students, interns, externs, residents, and health care professionals.
• Reviews a completed prior authorization request received from the provider and/or reviews the pharmacy technician s recommended denial, suggested formulary alternatives, comments and attachments for appropriateness.
• Verifies member s ID number and date of birth.
• Verifies member s eligibility in the appropriate health plan eligibility system.
• Records carrier and group number if applicable.
• Checks for previous prior authorization decisions.
• Verifies coverage in member s prescription benefit when necessary.
• Verifies coverage in member s health plan benefit when necessary.
• Evaluates prescription claim history.
• Reviews chart notes and/or lab values.
• Identifies provider specialty when appropriate.
• Applies Medical Policy Criteria to prior authorization requests.
• Evaluates whether request meets criteria for approval.
• Reviews the request using professional clinical judgment on a case by case basis. A pharmacist will review medication requests not addressed by P&T Committee criteria or guidelines, develop and draft criteria for the non-formulary medication requested.
• Researches and contributes drug references and clinical information to facilitate prior authorization review: directly to physicians via fax or phone encounter; or to pharmacy technicians via memo or on a personal level as an educational tool
• Communicates with physicians regarding prior authorization:
• For a non-formulary drug
• Plan benefits, exclusions
• Quantity limits
• Age restrictions
• Formulary alternatives
• Retrieves and collects data through available reporting resources (i.e. Discoverer, IT Department)
• Compiles data for reporting purposes:
• Drug utilization of non-formulary drugs
• Overturned IPS recommended denials
• Audit pharmacy claims greater than $200.00
• Suggest addition or deletion of drugs to/from the formulary
• Updating qty/days or age limit ends
• Support National P&T Committee
• Other tasks which may arise during the performance of any of the above mentioned duties.

Key Requirements and Technology Experience:

• Key skills; Clinical Pharmacists
• Prior Authorization
• Medicare, Medicaid
• Must haves: At least one year of professional RPh experience
• Nice to haves: Some experience working in managed care, understanding of Medicare/Medicaid law
• Sef-Motivated/Good Time Management Skills
• Working Knowledge of Office Suite
• Goal Oriented
• Education/Certification Required: Pharm D.
• Licensure ; Required: Any US state

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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