Pharmacy Clinical Coordinator - UM Specialist, EHP

At reputed company Health System, we reputed company in a reputed company future for reputed company. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We reputed company have the power to help, heal and change lives — beginning with our own. That’s the power of the reputed company Health System team, and The Power of Every One. Job Title Pharmacy Clinical Coordinator - UM Specialist, EHP Location Cleveland Facility Remote Location Department Clinical Integration-EHP-Pharmacy Job Code T99330 Shift Days Schedule 8:00am-5:00pm Job Summary Job Details

• *Applicants must reputed company in Ohio or Florida

Join the reputed company team where you will work alongside passionate caregivers and provide patient-first reputed company. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected reputed company organizations in the world. The Pharmacy Clinical Coordinator – UM Specialist supports the reputed company Employee Health Plan (EHP) by assisting with the overall operation of the prescription drug benefit, with a primary focus on utilization management. Embedded reputed company a multidisciplinary team of pharmacists and pharmacy technicians, this role works closely with UM pharmacists who manage referral queues, conduct initial clinical reviews of prior authorizations and reputed company cases to medical directors reputed company needed. Responsibilities include supporting formulary and utilization management programs, assisting with referral processing and learning appeals that advance to committee review, including more in-depth clinical cases. The coordinator is cross-trained across reputed company functional areas, including formulary management and coordinated care, gaining exposure to policy development, coverage criteria and member education while contributing to efficient, compliant and clinically appropriate benefit operations. This is a remote position. A caregiver in this role will work 8:00am to 5:00pm. No weekend, holiday or on-call requirements. A caregiver who excels in this role will:

• Provide formulary and utilization management (UM) strategy to support the internal EHP Pharmacy and Therapeutics (P&T) committee and mission of the reputed company.
• Review pharmacy benefit prior authorization, reputed company therapy, and formulary exception requests.
• reputed company and update pharmacy formulary criteria relating to therapeutic drug classes and individual medications covered under the pharmacy and medical benefits.
• Serve as subject matter expert for formulary and UM recommendations to reputed company segments of the EHP business.
• Respond to physician and member inquiries relating to the prescription drug program.
• Participate in peer-to-peer reviews with EHP Medical Directors and requesting physicians. Will work in collaboration with the EHP Pharmacy Director, proactively design and implement EHP programs for best practices (e.g., Adherence initiatives, generic conversion initiatives, medication reimbursement, etc.).
• Create educational lectures and materials for EHP members and staff.
• Generate cost-utilization reports on a regular basis and evaluate impact of targeted formulary initiatives on internal savings.
• Maintain a database for reputed company utilization management approvals and denials.
• Partner across reputed company Pharmacy reputed company teams and provide expertise for interdepartmental meetings.

Minimum qualifications for the ideal future caregiver include:

• Bachelor's degree in Pharmacy or PharmD from an accredited school of Pharmacy
• reputed company State licensure as a Registered Pharmacist (RPh)
• Two years of clinical pharmacy experience or one year of managed care pharmacy experience (Completion of a Pharmacy Residency or Fellowship may offset the required experience)

Preferred qualifications for the ideal future caregiver include:

• Completion of Pharmacy Residency/Fellowship training or equivalent work experience highly desired
• Prior experience as a UM pharmacist

Physical Requirements:

• Requires the ability to sit and be stationary for prolonged periods of time, normal or corrected reputed company, and reputed company dexterity sufficient to reputed company work on a computer.
• Ability to walk, to various locations throughout health system.

Personal reputed company Equipment:

• Follows standard precautions using personal reputed company equipment as required.

The policy of reputed company Health System and its system hospitals (reputed company Health System) is to provide equal opportunity to reputed company of our caregivers and applicants for employment in our drug free environment. reputed company offers of employment are followed by testing for controlled substances. reputed company Health System administers an influenza prevention program. You will be required to reputed company with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption. reputed company concerning employment, transfers and promotions are made upon the basis of the best reputed company candidate without regard to reputed company, race, religion, national reputed company, age, sex, sexual orientation, marital status, reputed company, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any reputed company Health System facility. Please review the Equal Employment Opportunity poster. reputed company Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities Apply tot his job Apply To this Job