Clinical Pharmacist – Utilization Management

Responsibilities

• Develop and deliver clinical messages to physicians, members, clients, and consultants
• Manage prior authorization, high-cost cases, claims editing and clinical policy development
• Clinical program development including both medical and pharmacy benefit management
• Define, document, and deliver results for plan sponsors
• Evaluate and summarize clinical literature as well as financial implications related to medication management options
• Ability to present deep clinical and cost effectiveness information as a peer-to-peer consult

• Doctor of Pharmacy (PharmD)
• Current pharmacist license (RPh) in good standing with a State Board of Pharmacy
• Board of Pharmacy Certification, preferred for Pharmacotherapy, Ambulatory Care or Oncology Care
• 3 years clinical or managed care experience or Clinical/Managed Care Pharmacy Residency preferred
• Pharmacy and Medical specialty benefit knowledge and experience
• Independent, proactive, forward-thinking, creative problem solver, results-oriented
• Ability to work well in team environment
• Strong verbal/written communication skills
• Strong physician-facing clinical communication skills
• Microsoft Excel, Power Point and Word proficiency