Utilization Management Clinical Pharmacist 2 (Contract)
About The Position
The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Utilization Management Clinical Pharmacist 2 (VSP/PT) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Clinical Pharmacist 2 (VSP/PT) completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns. Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes, as needed. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
Requirements
- Bachelor's degree/Pharm.D
- Must have an active license with the Board of Pharmacy in the state of residence
- Pharmacy degree from an accredited college of pharmacy
- Ability to participate in Federal prescription programs (Medicare/Medicaid reviews)
- Self-directed, but also able to work well in a group
- Ability to solve problems and encourage others in collaborative problem solving
- Work ethic that is focused, accurate, and highly productive
- Strong communication skills
- Proficient with computers -- various systems
Nice To Haves
- Managed care experience - specifically Utilization management review
Responsibilities
- Completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
- Completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns.
- Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes, as needed.
- Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
- Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
- Follows established guidelines/procedures.
Benefits
- paid time off
- 401(k) retirement savings plan
- employee assistance program
- business travel and accident
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What This Job Offers
Career Level
Mid Level
