Utilization Management Pharmacy Intern

Univera Healthcare•Rochester, NY

11d•$20 - $33

About The Position

Summary: Under the guidance of the Clinical Pharmacists, other clinical team members and divisional management, this position supports and participates in a wide range of provider, customer and staff initiatives/programs including Utilization Management; Quality/Disease Management; Drug Utilization Review; Staff, and customer service support/training. The incumbent also provides administrative support to current processes, as needed, in order to maintain operational efficiencies for clinical-based Prescription Drug Management programs across all regions. Supports Drug Information Services and other specific clinical initiatives participation and management, as determined. This position works as part of the clinical team to improve the appropriateness of provider prescribing patterns and our members’ use of medication by conducting concurrent/retrospective and prospective prescription drug utilization analysis; evaluating and making determinations on drug program exception requests and medical necessity prescription utilization reviews where legally appropriate. Essential Accountabilities: Supports and participates in a wide range of provider, customer and staff initiatives/programs including Utilization Management; Quality/ Disease Management; Drug Utilization Review; Staff, and customer service support/training. Provides administrative support to current processes as needed in order to maintain operational efficiencies for clinical based Prescription Drug Management programs across all of Health Plan regions. Provides Drug Information Services support and other specific clinical initiatives participation and management, as determined. Works as part of the clinical team to improve the appropriateness of provider prescribing patterns and our members’ use of medication by conducting concurrent/retrospective and prospective prescription utilization analysis; evaluating and making determinations on drug program exception requests and medical necessity prescription utilization reviews where legally appropriate. Effectively utilizes clinical research and investigative tools to research and present drug information and data to the clinical staff. Performs clinical drug research in support of policy implementation and generation. Performs medication therapy management including direct counseling and contact with our members as directed by the supervising pharmacist. Actively completes drug comparison and research data as directed to provide information for our Pharmacy and Therapeutic (P&T) committee meetings as directed by the supervising pharmacist. Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management

Requirements

Must successfully complete the first professional year of study in an Accreditation Council for Pharmacy Education (ACPE) program and eligible to apply for a limited (intern) permit. (This permit will authorize practice as a pharmacist under the immediate personal supervision of a licensed pharmacist in New York State)
Strong customer service orientation, knowledge of drug information process/references, research/statistical study design.
Must be professional, articulate, knowledgeable; have excellent organizational, project management and drug information retrieval skills; written and oral communication skills.
Capable of working independently and applying problem-solving and analytical abilities to situations where no precedent exists.
Strong computer skills.
Proficient knowledge of Microsoft Word and Excel.
Strong problem-solving abilities, recognizes problems, develops problem-solving strategies and evaluates the effectiveness of solutions.

Responsibilities

Supports and participates in a wide range of provider, customer and staff initiatives/programs including Utilization Management; Quality/ Disease Management; Drug Utilization Review; Staff, and customer service support/training.
Provides administrative support to current processes as needed in order to maintain operational efficiencies for clinical based Prescription Drug Management programs across all of Health Plan regions.
Provides Drug Information Services support and other specific clinical initiatives participation and management, as determined.
Works as part of the clinical team to improve the appropriateness of provider prescribing patterns and our members’ use of medication by conducting concurrent/retrospective and prospective prescription utilization analysis; evaluating and making determinations on drug program exception requests and medical necessity prescription utilization reviews where legally appropriate.
Effectively utilizes clinical research and investigative tools to research and present drug information and data to the clinical staff.
Performs clinical drug research in support of policy implementation and generation.
Performs medication therapy management including direct counseling and contact with our members as directed by the supervising pharmacist.
Actively completes drug comparison and research data as directed to provide information for our Pharmacy and Therapeutic (P&T) committee meetings as directed by the supervising pharmacist.
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs.
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
Regular and reliable attendance is expected and required.
Performs other functions as assigned by management