Pharmacist - Clinical Pharmacist

ICONMA, LLC

4 hours ago

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Our Client, a Retail Pharmacy company, is looking for a Pharmacist - Clinical Pharmacist for their Remote location.

Responsibilities:

Complete Clinical Reviews and provide a determination of Medicare-Medicaid Coverage Determination/Redetermination, Global Exception etc. by reviewing all requests which are not clearly approvable based on specified criteria (algorithms).
Continually monitor the quality and efficiency of the Prior Authorization process including coverage criteria, denial language, and communication with prescribers and members. Provide recommendations to physicians to improve medication regimens as appropriate.
Complete all annual NCQA, client required training requirements.
Assists Member Services and other internal customers in responding to and resolving pharmacy-related inquiries from members (NCQA Requirement).
Maintain open lines of communication with other functional areas/departments.
Responsible for staying current with clinical literature and guidelines and relaying those to the program development core teams.

Requirements:

Background/experience (required)
Proficiency in Microsoft Excel, Word, Outlook, and SharePoint
Superior written and verbal communication skills
Will considered a recent grad with an active license
Background/experience (preferred)
Managed care experience (Medicaid/Medicare)
1+ year of previous clinical pharmacy experience required
2+ years of experience working as a pharmacist (managed care experience is highly desirable, but not required)
Knowledge of clinical program components, formulary designs, and prescription benefit trends preferred
Board certification and managed care residency preferred

Why Should You Apply?

Pharmacist - Clinical Pharmacist · ICONMA, LLC