Clinical Review Pharmacist

AmTrust Financial Services, Inc.; South Jordan (UT); On-site; USD 116,000 - 120,000; Full time

Benefits offered by this job

Medical & Dental Plans

401(k) Savings Plans

Paid Time Off

Job summary

AmTrust Financial Services, Inc. is seeking a Clinical Pharmacist based in South Jordan, Utah. This role involves reviewing medical necessity for workers' compensation medications and collaborating with AmTrust adjusters and nurses on patient care. The ideal candidate will possess a Pharmacy B.S. or Pharm.D. and at least 3 years of clinical pharmacy experience.

Responsibilities include assessing prior authorizations, documenting clinical judgments, and maintaining patient confidentiality. The position offers a competitive compensation package, including medical and dental plans, a 401(k), and paid time off.

Qualifications

• 3+ years of experience in pharmacy clinical care.
• Strong documentation and communication skills.

Responsibilities

• Review prescription prior authorizations in a timely manner.
• Document medication determinations based on clinical judgement.
• Engage providers for peer-to-peer interventions.

Skills

Clinical care experience

Strong documentation skills

Strong communication skills

Education

Pharmacy B.S. or Pharm.D.

Job description

Overview

AmTrust Financial Services, a fast‑growing commercial insurance company, has a need for a Clinical Pharmacist. Candidates located within a reasonable commuting distance of our South Jordan, Utah office will also be considered.

Primary Purpose

The Clinical Review Pharmacist has the responsibility of reviewing the medical necessity, appropriateness, and quality in the appropriate setting for workers’ compensation injured employees as it pertains to their medications. Additionally, they will work with Amtrust adjusters and nurses to take proper interventions in the care of the injured employee. This position primarily requires timely reviews of pharmacy prior authorizations to determine appropriateness and medical necessity of treatment. This position assesses the medical appropriateness of proposed medications for our injured employees and partners with the AmTrust claims team to expedite medically necessary treatment.

Responsibilities

• Review prescription prior authorizations in the timeliest manner.
• Perform supporting clerical tasks associated with pharmacy authorizations/reviews.
• Document medication determination based on professional clinical judgement, evidence‑based guidelines, clinical treatment guidelines, state‑specific workers’ compensation formularies, and third‑party utilization review when appropriate.
• Document judgement on medication determinations on multiple platforms.
• Recommend alternative medications, alternative dosing, or other modifications (including discontinuation of medications) as appropriate.
• Review therapy plans with case nurses as needed.
• Escalate cases for multi‑disciplinary reviews.
• Engage providers telephonically for peer‑to‑peer interventions.
• Participate in clinical quality audits for inter‑rater reliability assurance and support.
• Review medication orders for completeness, accuracy, and legality, determining the presence of medication therapy problems in a patient’s current medication therapy, including, for example, any of the following:
  • Medication prescribed inappropriately for a particular medical condition
  • Current medication therapy regimen is inappropriate (dose, dosage form, duration, schedule, route of administration, method of administration)
  • There is therapeutic duplication
• Provide pharmacological information by answering questions and requests of health care professionals and adjusters.
• Maintain privacy and confidentiality of all records while adhering to ethical, legal, and regulatory standards.
• Work independently and prioritize workload.

Qualifications

• 3+ years of experience in pharmacy clinical care.
• Pharmacy B.S. or Pharm.D.
• Strong documentation skills.
• Strong communication and presentation skills.

Preferred Experience

• Prior authorization experience.
• Pain management treatment protocols and clinical guidelines.
• Excellent oral and documentation communication skills.
• MTM certifications.
• Workers’ compensation managed care treatment.
• Clinical guidelines and formulary management.

What We Offer

• Competitive compensation package with salary range $116,000–$120,000.
• Medical & Dental Plans.
• Life Insurance, including eligible spouses & children.
• Health Care Flexible Spending.
• Dependent Care.
• 401(k) Savings Plans.
• Paid Time Off.

AmTrust values excellence and recognizes that by embracing diverse backgrounds, skills, and perspectives, we can sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain, and develop the best talent available.