Sr. Clinical Pharmacist- REMOTE

Prime Therapeutics • Home, WV

22h • $124,000 - $211,000 • Remote

About The Position

The Clinical Pharmacist is responsible for the clinical and regulatory analysis activities required for the implementation of clinical and regulated programs, including coverage lists in support of client benefits. This position is responsible for participating in internal, client-initiated and regulatory projects. This position is also responsible for supporting quality assurance needs and analytical activities related to benefit plans.

Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
• Current pharmacist license in good standing with the State Board of Pharmacy in the State where the position is located
• 1 year of work experience in clinical, retail, hospital, or managed care
• Must be eligible to work in the United States without need for work visa or residency sponsorship
• Must be eligible to work in the United States without the need for work visa or residency sponsorship
• Strong analytical and problem-solving skills with attention to detail and quality
• Ability to work on multiple projects simultaneously under pressure with strict timelines
• Ability to develop process efficiencies
• Ability to work well in team environment
• Microsoft Excel and Word proficiency

Nice To Haves

• MediSpan or First Databank experience
• Formulary Database management experience
• Knowledge of AS400, queries, and Lotus Notes
• RxClaim experience

Responsibilities

• Partner with Quality Audit team and/or other roles to develop and maintain project and benefit plan testing scenarios including utilization management, specialty and new client offerings
• Interpret project requests to determine feasibility, develop business requirements and assist with developing technical solutions
• Document process for execution and conduct User Acceptance Testing (UAT) for quality assurance
• Identify system problems, resolve set-up issues and/or escalate system defects with a sense of urgency to avoid member disruption
• Ensure benefit plans are in compliance with all regulations including federal, CMS, state, local and pharmacy
• Develop, maintain and verify drug lists with claims adjudication systems to support benefit coverage decisions and contingent therapy, quantity limits, and prior authorization programs
• Develop and maintain point of service messages and concurrent Drug Utilization Review table settings, and ensure accuracy of claims adjudication through weekly MediSpan product file maintenance and quarterly P&T implementation decisions
• Other duties as assigned

Benefits

• To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level