RN Pharmacy

Primary purpose of the role:
To utilize evidence‑based tools to evaluate prescribed medications to ensure patient safety and quality standards are aligned with best practice standards.

• Monday through Friday, 1:00PM – 9:00PM CST.
• Training:
  Monday through Friday, 8:00AM – 4:00PM CST (initial training).

• Perform clinical assessment via pharmacy reports and case files, including evaluation of psychosocial needs, cultural implications, and available support systems.
• Evaluate patient drug usage and physician prescribing patterns.
• Assess overuse, underuse, and misuse of prescribed medications and recommend testing for potential drug diversion.
• Recommend alternative treatments when necessary.
• Send letters to prescribing physicians and refer to physician advisors as needed.
• Negotiate appropriate level and intensity of care using medical and disability duration guidelines, adhering to quality assurance standards.
• Negotiate changes in pharmacy plans with providers.
• Serve as a resource in consulting with clients, nursing staff, and claims examiners regarding pharmacy issues.
• Conduct drug utilization reviews through the pharmacy benefit manager or vendor.
• Communicate effectively with claims examiners, clients, vendors, supervisors, and other parties.
• Maintain client privacy and confidentiality; promote client safety and advocacy; adhere to ethical, legal, accreditation, and regulatory standards.

• Active unrestricted RN license in a U.S. state or territory.
• Bachelor’s degree in nursing (BSN) from an accredited institution or equivalent work experience (preferred).
• Certification in case management, pharmacy, rehabilitation nursing, or a related specialty (highly preferred).
• Four (4) years of related experience or equivalent combination of education and experience, including two (2) years of direct clinical care or two (2) years of case management/utilization management.

• Computer keyboard proficiency.
• Auditory:
  Hearing, vision, and speaking.
• Mental:
  Clear conceptual thinking, excellent judgment and discretion, ability to meet deadlines.

Salary range: $65,000 – $67,000 (actual compensation varies by skill set, experience, and location).

Benefits include medical, dental, vision, 401(k) and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.