Remote Clinical Pharmacist
Company: Rx Relief
Location: Commerce City
Posted on: April 8, 2021
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Job Description:
JOB DESCRIPTION Remote Clinical Pharmacist (Pharmacy Benefit
Management) Attention Pharmacists:Are you ready for a great new
remote opportunity?Join one of the nation's leading pharmacist
placement firms! Right now, Rx relief has a great opportunity for
an experienced Clinical Pharmacist (Pharmacy Benefit Management) .
Voted Best of Staffing by both clients and talent, we are a
specialty staffing company providing supplemental pharmacy
professionals for all pharmacy practice settings. We have an
opening for a Clinical Pharmacist (Pharmacy Benefit Management). As
a member of our team, you'll enjoy a customized approach to your
career needs as well as comprehensive benefits! Join our dynamic
team, apply today!With a salary starting at $57.00 Per Hour *, Rx
relief is looking for the right person to fill a Clinical
Pharmacist (Pharmacy Benefit Management) position---right now.Rx
relief offers a range of various benefits including: health
insurance, vision and dental insurance, 401(k) and deferred
compensation programs, and more!As a Clinical Pharmacist (Pharmacy
Benefit Management) , you will track coverage determination
requests for approvals, and provide support and input to clinical
programs, including health management, drug utilization review,
formulary development, pain management and prior authorization
programs. Your goals will be to encourage appropriate, high
quality, cost effective drug therapy, and to identify opportunities
for improvement in efficiency, accuracy and appropriateness of the
programs in place.*Salary dependent upon experienceClinical
Pharmacist (Pharmacy Benefit Management) Job Specifics and
Requirements- Area: Anywhere Licensure Requirements: Must have
open, active, and in good standing TX, OK, TN--State Pharmacist
License. All are not required but preferred.Education: PharmD.
Years of Experience: 1+ Years. Pain Management background preferred
Schedule: M-F 40 hours per week. Schedule--depends on the pharmacy
needs. Time zone is Central Time. Length of Assignment: Temporary
ongoing Pay: $57.00 per hour Equipment: Desktop or Laptop with high
speed internet of 50+--megabits required. Calls are web-based.
Background/ Drug Requirements: Ability to successfully complete
background check and drug screenClinical Pharmacist (Pharmacy
Benefit Management) Job Responsibilities: [j1] 21 reviews per month
are required. Participate in the coverage determination process
(certification, prior authorization, medical exception, exception
to coverage, etc.), by reviewing all requests which are not clearly
approvable based on specified criteria (algorithms).Make all
coverage denial determinations, identifying yourself by first name,
title, and responsibility in relation to drug utilization
management program administration.Continually monitor the quality
and efficiency of the coverage determination process, including
coverage criteria, denial language and communication with
prescribers.Provide input to clinical content for new and existing
programs.Complete all annual URAC training requirements.Participate
with core teams working on new program and/or product
development.Facilitate communication with and education of clients,
members and internal staff regarding daily clinical issues and
objectives.Provide support to operational departments on the
implementation of various PBM programs and functions, as part of
member/patient quality of care.Provide support and clinical
expertise related to formulary decisions made by the Pharmacy and
Therapeutics Committee.Review health care survey data for Medicare
Part D qualified participants and/or perform phone consultations
with Med-D enrollees; aid in documentation of calls; designate
enrollees for repeat interaction.Assist customer care, client
services and other internal customers in responding to and
resolving pharmacy-related inquiries from members, clients,
providers or pharmacies.Maintain open lines of communication with
other functional areas/departments.Participate in
multi-departmental meetings and committees to accomplish
projects.Responsible for staying current with clinical literature
and guidelines, and relaying such to program development core
teams.Review specialty medication prior authorization requests
(i.e. biopharmaceuticals) according to established treatment
protocols, clinical criteria and member benefits.Make coverage
determinations within the defined turnaround times, and meet
regulatory requirements.Responsible for clinical criteria for
specialty medications including analysis, monitoring of industry
trends.Develop criteria recommendations for the Pharmacy and
Therapeutics Committee, and clients.Define and coordinate prior
authorization and drug utilization reviews reports for clients, and
ensure that all regulatory reporting requirements for drug
utilization review, fraud and abuse reporting are met.Oversee drug
utilization review and medication therapy management programs for
specialty medications within the assigned plan to meet regulatory
requirements; develop systematic reviews of prescription claims to
meet strategic initiatives.Develop and design specialty medication
clinical edits for claims adjudication and enhanced drug
utilization review.Provide clinical guidance, support and oversight
to the assigned pharmacy technicians.Develop and review guideline
criteria for prior authorization and non-formulary drugs in support
of Pharmacy and Therapeutics Committee function and pharmacy
benefit design.Ensure and evaluate quality controls and implement
opportunities for performance improvement in pharmacy practice
specific to specialty pharmacies.Research drug information to
maintain drug knowledge and disease state understanding for
application to prior authorization reviews.Responsible for
maintaining productivity and quality standards, as well as legal
and company compliance.About Rx relief Rx relief is a specialty
staffing company providing supplemental pharmacy professionals for
all pharmacy practice settings. Voted Best of Staffing by both
clients and talent, we provide a customized approach to your career
needs as well as comprehensive benefits. Contact us to learn why
everything we do is all about YOU!Compensation / Pay Rate (Up to):
$57.00 Per Hour
Keywords: Rx Relief, Commerce City , Remote Clinical Pharmacist, Healthcare , Commerce City, Colorado
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