Managed Care Pharmacist

Renown Health
Reno, NV, United States
Full-time

Position Purpose :

Under the supervision of the Manager of Pharmacy Services, assists in coordinating, developing, implementing, and monitoring drug utilization review activities.

Assists with managing the formulary including education of members, providers, and internal staff about changes to the formulary and formulary management.

Reviews drug Prior Authorization request that come to Hometown Health. Provides Pharmacist support to Senior Care Plus Med D Plans.

Nature and Scope :

This position is responsible for the utilization review activities, formulary development and management, coordination of educational outreach to providers on a periodic basis related to MAPD and Medicare Part D Formularies.

To perform the functions of this position, the pharmacist must have :

  • Excellent oral and written communication skills;
  • Clinical background and the ability to work independently as well as in a team setting;
  • Communicate effectively with providers, members, and other operational departments of Hometown Health and our PBM;
  • Communicate and collaborate with many types of health care professionals;
  • Able to accept responsibility, and complete work on multiple assignments; and
  • Working knowledge of Government Pharmacy Programs such as Medicare Part D.

This position does not provide patient care. This position coordinates patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job.

It is intended to be an accurate reflection of the general nature and level of the job.

Minimum Qualifications : Requirements - Required and / or Preferred

Education :

Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelor of Pharmacy or preferably Doctor of Pharmacy Degree.

Appropriate education to obtain and maintain Registered Pharmacist licensure in the State of Nevada.

Experience :

Minimum of three years as a practicing pharmacist, in a managed care setting preferred (working knowledge of managed care, formularies, DUE / DUR process);

Medicare D benefit, management experience is preferred.

License(s) :

Current and unrestricted state of Nevada Pharmacy License

Certification(s) : Computer / Typing :

Computer / Typing :

Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

14 days ago
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