Senior Managed Care Pharmacist – DUR, MTM & Training Lead

UMass Chan Medical School; Westborough (MA); On-site; USD 110,000 - 145,000; Full time

Job summary

University of Massachusetts Chan Medical School seeks a Consultant Pharmacist IV to join Clinical Pharmacy Services. You will lead DUR-related activities, review and optimize drug therapy, and coordinate prior authorization processes while supervising Pharmacists and Pharmacy Associates.

The role requires licensure in good standing, pharmacy residency or equivalent experience, and willingness to travel to off-site locations. Expect diverse clinical duties and ongoing professional development.

Qualifications

• Bachelor of Science degree in Pharmacy; 3 years of work experience OR
• Doctor of Pharmacy degree with 2 years of pharmacy-related work experience or completion of 2 years of pharmacy residency OR
• Doctor of Pharmacy degree with completion of 1 year of pharmacy residency and 1 year of pharmacy-related work experience OR
• Doctor of Pharmacy degree with completion of managed care residency program

Responsibilities

• Provides orientation, training and guidance to Consultant Pharmacists and Pharmacy Associates
• Coordinates the prior authorization (RPA) process including data entry and reporting, ensuring 24-hour turnaround
• Participates in program planning and development
• Develops clinical drug use criteria for prospective and retrospective DUR reviews
• Researches member cases and represents client during prescription appeals
• Performs medication therapy management reviews of medical and medication profiles
• Reviews profiles and communicates with providers to optimize therapy
• Provides real-time drug therapy recommendations to prescribers
• Reviews documentation to determine medical necessity and compliance
• Decides authorization or denial of prior approvals via telephone with pharmacies
• Provides expertise to advisory boards and workgroups
• Monitors utilization patterns and identifies over/underutilization
• Assists in monitoring and researching member profiles for daily compliance
• Refers suspected abuse to program manager for case review
• Participates in provider site visits and agency meetings
• Leads or participates in quality improvement initiatives
• Performs other duties as assigned

Job description

University of Massachusetts Chan Medical School seeks a Consultant Pharmacist IV to join Clinical Pharmacy Services. You will lead DUR-related activities, review and optimize drug therapy, and coordinate prior authorization processes while supervising Pharmacists and Pharmacy Associates.

The role requires licensure in good standing, pharmacy residency or equivalent experience, and willingness to travel to off-site locations. Expect diverse clinical duties and ongoing professional development.