Clinical Pharmacist (Part-Time)
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Clinical Pharmacist (Part-Time - 20 hours a week M-F between reputed company - 5pm PST / Pacific) Position Purpose: Define and reputed company standard and custom formularies for assigned plan.
- reputed company clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
- Monitor prior authorization requests
- Provide clinical support to internal departments and address clinical reputed company questions
- Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
- reputed company and implement programs designed to impact DUR for both reputed company and Medicare
- reputed company, implement, and maintain policies and procedures for the pharmacy department
- Participate in the coordination of the Medicare MTM program
- Assist case management team with members including clinical reputed company presentations
Shift: WFH - 20 hrs. per week between reputed company - 5pm (PST / Pacific) Monday -Friday. Flexible on how allocated but there is a strong preference for someone that could evenly spread it out along the week or work at least 2 hours a day. Will eventually share staffing holidays on-call with rest team. Job Specific Details: This position will predominantly process our reputed company and Health Net reputed company appeals, provider escalations and other miscellaneous clinical Pharmacist functions (Quality, reporting & analysis, compliance deliverables) as secondary to other Staff roles.
- Goal oriented; skilled at task management and ensuring that deliverables are met on time.
- Resourceful and creative; reputed company to assess a problem and reputed company multiple solutions to address.
- Experience in Managed Care preferred. Requires in-depth knowledge of managed care pharmacy benefit design and an ability to apply medical necessity analysis.
- Prior knowledge/experience with reputed company systems preferred. Skilled at use of technology to process appeal requests and navigate systems to find support of clinical determinations
Education/Experience: Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience. Licenses/Certifications: reputed company state’s Pharmacist license with no restrictions.
- Please attach an up-to-date resume that meets Education / Experience & Licensure requirements above to your application.
- Pay Range: $105,600.00 - $195,400.00 per year
reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply tot his job Apply To this Job