Address
Form of work
SalaryPURPOSE OF THE ROLE
The Clinical Pharmacist will utilize their clinical expertise and knowledge to support the operations of the Clinical department. This position will support new and ongoing clinical initiatives and programs by working collaboratively within the Clinical department and with other SCL personnel. Additionally, they will be responsible for the oversight of the daily operations in the department in the absence of the Director of Clinical Services. This position will report directly to the Clinical Services Supervisor.
KEY TASKS AND RESPONSIBILTIES
- Review and assess clinical prior authorizations and letters of medical necessity that are provided by physicians
- Handle communication with physicians, pharmacies and/or patients regarding patient’s drug therapy
- Ensure proper medication utilization among patients
- Work the clinical queue within the SCL adjudication system as well as the prior authorization system
- Render certifications and non –certifications as needed
- Review all non-certification letters for accuracy prior to mailing to patient
- Provide clinical expertise and support to SCL personnel
- Assist with the redirection of compound prescriptions to compounding network
- Conduct and provide feedback on program testing
- Assist with the maintenance and documentation of formulary programs
- Serve and participate on the Quality Management Committee
- Assist and work cooperatively with personnel in the Fraud Waste and Abuse Department
- Assist and support ad hoc requests as deemed pertinent, as to not conflict with current roles and responsibilities
QUALIFICATIONS
- Registered pharmacist in good standing with the applicable State Board of Pharmacy
- Maintain education and certifications as required by applicable State Board of Pharmacy
- 5+years of experience in Pharmacy Benefit Management, specialty case management or specialty pharmacy preferred
PROFESSIONAL SKILLS, EXPERIENCES AND COMPETENCIES
- Excellent written and verbal communication skills, both internally and externally
- Able to support multiple tasks, initiatives and projects simultaneously with an explicit attention to detail
- Possess strong interpersonal skills and able to work collaboratively across departments
- Strong organization skills, able to manage multiple priorities and deadlines
- Proficiency in Microsoft Office suite and industry related software
