Pharmacist

Are you an experienced Pharmacist looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the Pharmacist position for you!

Daily Responsibilities of a Pharmacist:  

• Provide timely drug therapy for Medicaid health plan members by processing prior authorization and medical necessity requests for specialty medications

• Review specialty medication prior authorization requests (i.e. biopharmaceuticals) according to established treatment protocols, clinical criteria and member benefits. and 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 and develop criteria recommendations for Pharmacy and Therapeutics Committee and clients

• Define and coordinate prior authorization and drug utilization reviews reports for clients and ensure regulatory reporting requirements for drug utilization review and fraud and abuse reporting are met

• Oversee the drug utilization review and medication therapy management programs for specialty medications at the assigned plan to meet regulatory requirements and develop systematic reviews of prescription claims to meet strategic initiatives