Consultant Pharmacist IV — DUR & MTM Lead

University of Massachusetts Medical School; Westborough (MA); On-site; USD 110,000 - 140,000; Full time

Job summary

University of Massachusetts Medical School seeks a Consultant Pharmacist IV to join Clinical Pharmacy Services. You will support DUR programs, manage prior authorization processes, and provide clinical drug use criteria development.

This role includes training and indirect supervision of other pharmacists and associates. The position interacts with physicians and pharmacists, reviews drug therapy, and makes real-time recommendations to prescribers to ensure appropriate, compliant patient care

Qualifications

• Bachelor of Science degree in Pharmacy with 3 years of work experience
• Doctor of Pharmacy degree with 2 years of pharmacy-related work experience or completion of 2 years of pharmacy residency
• Doctor of Pharmacy degree with completion of 1 year of pharmacy residency and 1 year of pharmacy-related work experience
• Doctor of Pharmacy degree with completion of managed care residency program
• Eligibility for licensure or current pharmacist license in good standing in the Commonwealth of Massachusetts
• Ability to travel to off-site locations

Responsibilities

• Provides orientation, training, guidance and direction, to Consultant Pharmacists and Pharmacy Associates
• Coordinates the request for prior authorization (RPA) process including data entry and the generation of reports
• Participates in program planning and development
• Participates in the development of clinical drug use criteria for the prospective and retrospective review components of the DUR Program
• Researches member's case and may represent the client during appeal processes regarding prescription medications
• Performs medication therapy management comprehensive and targeted medication reviews of medical and medication profiles
• Reviews member's medical and medication profiles and interacts with health care providers and client members to review appropriate drug therapy
• Provide real-time drug therapy recommendations to prescribers
• Reviews clinical documentation submitted by treating physicians and pharmacists to determine medical necessity and program compliance
• Decides in real time via telephone communications with pharmacies the authorization or denial of prior approval requests for prescription medications
• Provides pharmaceutical expertise and knowledge to the advisory board's clinical workgroups
• Monitors over-utilization and under-utilization of prescribed medicines for members
• Assists in monitoring and researching profiles for compliance on a daily basis
• Refers suspected abuse and fraudulent members to the program manager or designee for case review
• Participates in site visits to Provider offices, as necessary
• Participates in agency meetings as requested
• Leads and participates in quality improvement and quality assurance initiatives
• May perform other job related duties as assigned or requested

Skills

Team leadership

Prior authorization

Clinical decision-making

Pharmacy knowledge

Quality improvement

DUR expertise

Education

Bachelor of Science degree in Pharmacy

Doctor of Pharmacy degree

Pharmacy residency program

Managed care residency program

Licensure eligibility / current pharmacist license in MA

Ability to travel to off-site locations

Job description

University of Massachusetts Medical School seeks a Consultant Pharmacist IV to join Clinical Pharmacy Services. You will support DUR programs, manage prior authorization processes, and provide clinical drug use criteria development.

This role includes training and indirect supervision of other pharmacists and associates. The position interacts with physicians and pharmacists, reviews drug therapy, and makes real-time recommendations to prescribers to ensure appropriate, compliant patient care