Clinical Pharmacist

Emergent Holdings•Lansing, MI

5d•$107,000 - $179,300

About The Position

The Clinical Pharmacist is responsible for promoting appropriate and/or efficient utilization review of prescription drug claims among BCBSM participating physicians. This position is also responsible for the education of physicians and influencing of prescribing patterns to reduce BCBSM’s drug benefit payout and improve the quality of the benefits as it relates to our members. The incumbent serves as the liaison to the Medical Policy department assisting with the development of medical policy as it applies to drugs.

Requirements

Bachelor’s degree or Doctorate in Pharmacy.
Current unrestricted Pharmacy License required, MI Pharmacy License preferred.
Three years of experience consulting with physicians on pharmaceutical issues or completion of an accredited American Society of Health-System Pharmacists/Academy of Managed Care Pharmacy, AMCP/ASHP, Managed Care Pharmacy or Pharmacy Practice Residency.
Drug Information Specialist with proven background and skills may also be considered.
Superior oral and written communication skills and expertise in the design of presentations.
Ability to obtain and devise relevant data and information from existing MIS Systems.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write reports, business correspondence, and procedure manuals.
Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Nice To Haves

An understanding or knowledge of drug claims processing systems and/or medical information systems is preferred.

Responsibilities

Provides clinical coverage review for medication requests.
Develops, implements, and updates Drug Utilization Review/Due Programs.
Provides effective and efficient communication of pharmacotherapy issues.
Develops and implements a variety of behavior modification principles to influence physicians to prescribe appropriately.
Identifies target physicians, establishes credibility and utilizes both verbal and written communications to modify behavior.
Serves as the key clinical support person for researching prescription drug inquiries.
Develops, implements and monitors the Corporate Drug Information Center.
Develops, implements and continually updates physician and patient educational materials.
Supports Drug Formulary development and serves on the BCBSM P and T Committee.
Serves as liaison to medical Policy assisting with the development of medical policy as it applies to drugs.
Participate in clinical and operational process improvement and cost savings opportunities.
Support review and resolution of clinical and compliance grievances and appeals.
Support clinical initiatives related to NCQA, HEDIS, CAHPS and STAR measures.
Adhere to Pharmacy Policies and Procedures.