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Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.Job Posting TitleMedicare Part D Senior Clinical Pharmacist - RemoteJob Description SummaryServes as client or subject matter expert for an assigned client and/or program. Performs prospective and/or retrospective drug utilization reviews and appeals review per State and Federal regulations. Coordinates the distribution of clinical drug information as well as educate staff on the use of pharmaceutical treatment regimens and criteria. Serves as a training resource, mentor, subject matter expert and coach to clinical pharmacy technicians, and other clinical staff. Complies with all corporate and facility standard operating procedures, policies, guidelines, and work instructions.Job Description
Acts as prior-authorization liaison to the client and to the account management team.
Advises and assists with clinical edit implementation, participates in appeals determination at the client level.
Measures and reports on required contractual requirements.
Assists with client and internal reports for data validation and research escalated issues.
Collaborates with clinical account manager and other personnel in developing treatment guidelines and program enhancements.
Participates in plan formulary development and criteria management as required by the client.
Supports the Pharmacy and Therapeutics Committee.
Validates the clinical availability of multisource products for provider utilization.
Coordinates clinical activities for new implementations.
Assesses, investigates and resolves escalated issues to achieve client satisfaction, which may include Peer to Peer reviews, denial, and appeal processes.
Ensures timely and accurate delivery of reports to clients and management.
Provides clinical and operational support to staff pharmacists.
Serves as the client-specific technical on-site resource.
Assists with training for new clinical staff.
Conveys clinical updates to team as required.
Assesses training needs within team.
Serves as training resource, mentor and coach to others, particularly new hires.
Identifies and shares best practices.
Provides input into pharmacists' performance reviews.
Demonstrates, advocates and reinforces a positive team environment, professionalism, and the need to present a positive image of the company when interacting with others.
Coordinates clinical staff availability and activities surrounding new implementations, provide assistance with Requests For Proposals (RFPs), Requests For Information (RFIs), Best and Final Offers (BAFOs), and re-bid requests.
Adheres to organizational policies and procedures and ensuring compliance with Federal laws, State laws and standards of practice which govern the profession of pharmacy.
Maintains pharmacy records in accordance with all applicable State and Federal laws and regulations.
Maintains clinical skills and knowledge of pharmacotherapy by reviewing the literature, continuing education, and any company provided in-services. Completes all mandatory company provided on-line courses.
Attends and completes all employee development courses.
Participates in mandatory on-call rotation when required by business needs.
Makes outbound or takes inbound telephone calls to assist in various aspects of patient care and/or product distribution to/from practitioners, members, and pharmacies. These calls include, but are not limited to, comprehensive medication reviews, targeted medication reviews, call to practitioners about product awareness, and prior authorizations.
Minimum Qualifications:
PharmD, Doctor Of Pharmacy, State Licensure – Pharmacy
RPH – Registered Pharmacist – Pharmacy
3+ years of experience as a clinical pharmacist
Responsibilities
3+ years of experience as a clinical pharmacist required.
Strong drug product and clinical pharmacy knowledge.
PharmD required. Current incumbents grandfathered without the PharmD.
Work ExperienceWork Experience - Required:PharmacyWork Experience - Preferred:EducationEducation - Required:Bachelors - Pharmacy, PharmD - PharmacyEducation - Preferred:CertificationsCertifications - Required:PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy - Pharmacy, RPH - Registered Pharmacist - Pharmacy - PharmacyCertifications - Preferred:Potential pay for this position ranges from $95,840.00 - $162,920.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) and click on the "Benefits at a glance" button for more detail.Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.
