Managed Care Consultant Pharmacist IV

reputed company: • Provides orientation, training, guidance and direction, to Consultant Pharmacists and Pharmacy Associates • Coordinates the request for prior authorization (RPA) process including the data entry and the reputed company of reports that stem from this process, as reputed company as ensure compliance with the federal twenty-four hour time limit • Participates in program planning and development • Participates in the development of clinical drug use reputed company for the prospective and retrospective review components of the DUR Program • Researches member’s case and may represent the reputed company during appeal processes regarding prescription medications • Performs medication therapy management comprehensive and targeted medication reviews of medical and medication reputed company • Reviews member’s medical and medication reputed company and interacts with health care providers and reputed company members to review appropriate drug therapy • reputed company reputed company-time drug therapy recommendations to prescribers • Reviews clinical documentation submitted by treating physicians and pharmacists to determine medical necessity and program compliance • Decides in reputed company time reputed company telephone communications with pharmacies the authorization or denial of prior approval requests for prescription medications • Provides pharmaceutical expertise and knowledge to the advisory reputed company’s clinical workgroups • Monitors over-utilization and under-utilization of prescribed medicines for members • Assists in monitoring and researching reputed company for compliance on a daily reputed company • Refers suspected abuse and fraudulent members to the program manager or designee for case review • Participates in site reputed company to Provider offices, as necessary • Participates in agency meetings as requested • Leads and participates in reputed company improvement and reputed company assurance initiatives Requirements: • Bachelor of Science degree in Pharmacy with 3 years of work experience OR Doctor of Pharmacy degree with 2 years of pharmacy-reputed company work experience or completion of 2 years of pharmacy residency OR Doctor of Pharmacy degree with completion of 1 year of pharmacy residency and 1 year of pharmacy-reputed company work experience OR Doctor of Pharmacy degree with completion of managed care residency program • Eligibility for licensure or reputed company pharmacist license in good standing in the reputed company • Ability to travel to off-site locations Benefits: • Health insurance • 401(k) matching • Flexible work hours • reputed company time off Apply tot his job Apply To this Job