TotalMed Professional Madison, WI
- Expired: over a month ago. Applications are no longer accepted.
Job Title: Clinical PA Pharmacist
Salary range - $52/HR
Hours: Monday – Friday 8:00 am - 7:00 pm (Rotating Weekend Shifts)
Location: Madison, WI
Summary of the position:
-Responsible for support and input to clinical programs such as: Health Management, Drug Utilization Review, Formulary development, and Prior Authorization programs 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.
-Participate in the Coverage Determination (Certification, Prior Authorization, Medical Exception, Exception to Coverage, etc.) process be reviewing all requests which are not clearly approvable based on specified criteria (algorithms), making all coverage denial determinations, and identifying themselves 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 of new programs and for maintenance of existing programs.
-Complete all annual URAC training requirements
A minimum of a Bachelors Degree in Pharmacy or Pharm D. Current unrestricted licensure as an RPh in the State of the home office of the pharmacist, or the ability to gain reciprocity within 4 months of employment is required
Preferred experience is a minimum two years clinical experience, or clinical or managed care pharmacy practice residency. Knowledge of PBM industry, formulary management, pharmacy claims and managed care principles and practices desired. Exceptional clinical skills and ability to apply sound clinical judgment to a variety of situations is necessary.
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