Pharmacist

Qlarant; United States; Remote; USD 85,000 - 120,000; Full time

Job summary

Qlarant is seeking a Pharmacist with Medicare Part D experience, preferably from a Managed Care or Provider Benefit Manager background. This remote opportunity involves managing audits for Medicare, overseeing pharmacy services, and ensuring compliance with project specifications within the healthcare sector.

Qualifications

• Registered pharmacist with active license.
• 3-5 years experience in practice including Medicare.
• Experience with Medicare Part D strongly preferred.

Responsibilities

• Manage day-to-day operations of assigned projects.
• Build partnerships with stakeholders and drug plans.
• Ensure project deliverables are met on time.

Skills

Communication

Mathematical Skills

Organizational Skills

Interpersonal Skills

Independent Work

Education

Bachelor’s degree in pharmacy

Master's degree in pharmacy or Pharm.D.

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Project Management software

Job description

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.

Best People, Best Solutions, Best Results

Job Summary:

Qlarant has an opportunity for a Pharmacist with Medicare Part D experience preferably in a Managed Care/Provider Benefit Manager setting. This position will support the Program Audits conducted by the Centers for Medicare and Medicaid Services. The ideal candidate will have experience with Medicare Formulary Administration and/or Medicare Part D Coverage Determinations, Appeals and Grievances. This position can be home-based in most areas of the continental US. They will be responsible for facilitating and managing assigned projects and contracts relating to pharmacy services. Leads and provides oversight to assigned tasks and contracts, making sure that contract specifications are understood, tasks are assigned appropriately, and information is available and circulated.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Manages the day-to-day operations of assigned projects, as well as inter-project and cross-setting coordination of resources among projects; and contracts including facilitation and communication of resolution of barriers.
• Prioritizes, delegates, and accomplishes tasks and programs independently and in a team to ensure successful implementation of goals and objectives.
• Works with the appropriate stakeholders and drug plans to build partnerships, support data sharing, develop tools and references to support changes in care practices in the pharmacy arena.
• Reviews and interprets contract deliverables to ensure timely and accurate completion.
• Leads the design and application of work plans, as well as coordinating their evaluation and any needed modifications to ensure they reflect project work.
• Contributes to the conceptual design and implementation of projects, as well as assist with project execution as needed.
• Ensures all project deliverables and timelines are met and reports on variances in a timely manner.
• May provide educational programs as necessary to meet project goals and promote high quality, safe, and effective medication use.

Required Skills

To perform the job successfully, an individual should demonstrate the following competencies:

• Language Skills
• Ability to read, analyze, and interpret common scientific and technical journals and legal documents.
• Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
• Ability to effectively create and present information.
• Ability to communicate both verbally and in writing at a professional level.
• Mathematical Skills
• Ability to calculate, apply, and interpret mathematical concepts including but not limited to averages, percentages, frequency distributions, ratios, and percentiles.
• Reasoning Ability
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
• Computer Skills
• Intermediate or above level skills in Microsoft Word, Excel and Outlook; knowledge of Project Management software preferred.; knowledge of Project Management software preferred.
• Other Skills and Abilities
• Ability to work independently with appropriate coordination among project staff, partners and customers.
• Highly organized, able to work in a fast-paced environment, able to juggle multiple projects and assign proper priority, able to switch among tasks quickly and calmly.
• Excellent interpersonal skills and ability to work with and through people to get the job done.
• Assertive and diplomatic; able to establish credibility very quickly.
• Ability to develop and maintain long term working relationships.
• Accurate, thorough, detail oriented with excellent follow-through.

Required Experience

Education and/or Experience:

• Registered pharmacist, Bachelor’s degree in pharmacy, with Master's degree in pharmacy or Pharm.D.
• Degree with three to five years’ experience in practice (retail, health-systems, consulting, industry or academia).
• Medicare Part D Plan or PBM, and/or previous CMS Program Audit experience strongly preferred.

Certificates, Licenses, Registrations:

• Active, current and non-restricted Registered Pharmacist (RPh) license in the areas required by the contract.

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.