Clinical Pharmacist

Job Description

Provides pharmacotherapy expertise in support of the Pharmacy and Therapeutics (P&T) Committee, and drug formulary, prior authorization, drug utilization review, and physician education programs.

• Prior Authorization Process:
  Perform clinical review of PAs/MRFs.
• Pharmacy Review Committee:
  Prepare for bimonthly or monthly meetings (new drug reviews for CA and Medi-Cal formularies, drug class reviews for CA).
• Clinical Pharmacy Program – CPOP, MTM‑LTC, Pharmacy Case Review, CMS Star Rating Clinical Initiatives.
• HPSM/UOP and HPSM/USC Managed Care Internship:
  Perform intern teaching/preceptor duties.
• Give support for the development and maintenance of an internal Health Plan Drug Formulary for all product lines.
• Provide pharmacist support for the drug prior authorization program and review drug treatment authorizations.
• Provide clinical pharmacist expertise to the HPSM Clinical Pharmacy Program in the following clinical initiatives and intervention programs such as:
  • Clinical Pharmacy Outreach Program (CPOP)
  • MTM Program for Long Term Care Patients
  • Pharmacy Case Review of High Utilizers, Narcotic Utilizers, Adverse Drug Interaction Reports, Poor Medication Adherence Reports
  • Clinical Initiatives Related to CMS Part D Plan Star Rating

Day to Day Duties:

• Prior Authorization Process:
  Perform clinical review of PAs/MRFs.
• Pharmacy Appeals Process: perform clinical review of appeals and redetermination requests.
• Help with pharmacy claims adjudication, benefit and formulary problems generated from external and internal inquiries.
• Act as preceptor for pharmacy interns.

This person must:

• Communicate effectively, verbally and in writing.
• Proficiently use computers and related software applications.
• Provide effective customer service.
• Demonstrate sound math, analytical, and problem solving skills.

License and Certificates:

• Licensure as a Pharmacist in the State of California.

Education and Experience:

• Pharm
  
  D from an ACPE accredited college of pharmacy program is preferred.
• Equivalent to two years of work in a clinical pharmacy.
• Managed care and drug information center experience is a plus.

Knowledge of:

• Therapeutic drug utilization.
• Medicare Part D and Medi‑Cal.

Are you an experienced Clinical Pharmacist looking for a new opportunity with a prestigious healthcare company as an Clinical Pharmacist? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes” to any of these questions – this is the position for you!

To be considered please apply to this job post!