Job Profile Summary
Position Purpose: Define and develop standard and custom formularies for assigned plan.
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: Current state s Pharmacist license with no restrictions.
Responsibilities
" Develop 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 related questions
" Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
" Develop and implement programs designed to impact DUR for both Medicaid and Medicare
" Develop, 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 rounds presentations
EEO:
Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.
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Job Profile Summary
Position Purpose: Define and develop standard and custom formularies for assigned plan.
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: Current state s Pharmacist license with no restrictions.
Responsibilities
" Develop 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 related questions
" Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
" Develop and implement programs designed to impact DUR for both Medicaid and Medicare
" Develop, 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 rounds presentations |
| Story Behind the Need |
- What is the purpose of this team?
- What is driving this need? (ex. Backfill for FTE or CW, new project, business growth)
- Describe the surrounding team (team culture, work environment, etc.) & key projects.
- Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?
| We provide medication reviews for members that have qualified for one of our pharmacy clinical programs. Currently we have a clinical program expanding and need additional support temporarily. No further hiring needs. |
| Typical Day in the Role |
- Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
- What are performance expectations/metrics?
- What makes this role unique?
| Pharmacist will be expected to review a patient s medical information and pharmacy claims for gaps in care, drug therapy problems, etc. Expectation is 90% productivity daily. |
| Candidate Requirements |
| Education/Certification | Required: B.S. in Pharmacy or PharmD | Preferred: |
| Licensure | Required: required to be licensed in state of residence | Preferred: |
Years of experience required: at least 2 years MTM experience
Disqualifiers: Not having MTM experience
Additional qualities to look for:NA |
- Top 3 must-have hard skills stack-ranked by importance
| 1 | Work independently |
| 2 | Critical thinking |
| 3 | Clinical skill |
| Candidate Review & Selection |
- Shortlisting process
- Candidate review & selection
- Interview information
- Onboard process and expectations
| Projected Manager Candidate Review Date: | 1-2 days post shortlisting |
Type of Interviews:
| Teams |
| Required Testing or Assessment (by Vendor): | na |
| Next Steps |
- Do you have any upcoming PTO?
| No |
- Colleagues to cc/delegate
| None |
| Compliance Questions |
- (Department of Defense) Will this role operate, support, or utilize DOD data, systems, and/or infrastructure, requiring a National Agency Check with Law and Credit Checks (NACLC)? (Vendors: If yes, NACLC check is required).
| No |