Clinical Pharmacist: Coverage & Care Optimization
Quantum Recruiters Inc
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Resumo da oferta
PacificSource Health Plans is seeking a Clinical Pharmacist to coordinate pharmaceutical services for members, review coverage determinations, and promote high-quality, cost-effective care. This role collaborates with medical directors, providers, and pharmacy teams to ensure compliant services and optimal outcomes.
The position requires a Doctor of Pharmacy or pharmacy licensure and at least two years of pharmacy experience, with knowledge of federal and state regulations important for success.
Qualificações
- Pharmacist must have Doctor of Pharmacy degree or be a licensed pharmacist.
- Knowledge of federal and state regulations related to insurance pharmacy services.
- Ability to assess pharmaceutical alternatives and treatment plans.
Responsabilidades
- Provide accurate and timely drug coverage determinations based on criteria and standards.
- Support Part D Star measures through member outreach and interventions.
- Communicate effectively with members, providers, and internal staff via calls, letters, and email.
- Stay up to date on State and Federal regulations related to health insurance coverage and pharmacy practice.
- Support process improvements and departmental projects as assigned.
Conhecimentos
Formação académica
Descrição da oferta de emprego
PacificSource Health Plans is seeking a Clinical Pharmacist to coordinate pharmaceutical services for members, review coverage determinations, and promote high-quality, cost-effective care. This role collaborates with medical directors, providers, and pharmacy teams to ensure compliant services and optimal outcomes.
The position requires a Doctor of Pharmacy or pharmacy licensure and at least two years of pharmacy experience, with knowledge of federal and state regulations important for success.
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