• Job Description

  Req#: 25-67950
  
  Job Profile Summary
  Position Purpose: Define and develop standard and custom formularies for assigned plan.
  
  Education/Experience: Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.
  
  Licenses/Certifications: Current state’s Pharmacist license with no restrictions.
  
  Responsibilities
  • Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
  • Monitor prior authorization requests
  • Provide clinical support to internal departments and address clinical related questions
  • Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
  • Develop and implement programs designed to impact DUR for both Medicaid and Medicare
  • Develop, implement, and maintain policies and procedures for the pharmacy department
  • Participate in the coordination of the Medicare MTM program
  • Assist case management team with members including clinical rounds presentations
  
  EEO:
  
  “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
  
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  Job Profile Summary
  Position Purpose: Define and develop standard and custom formularies for assigned plan.
  
  Education/Experience: Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.
  
  Licenses/Certifications: Current state’s Pharmacist license with no restrictions.
  
  Responsibilities
  • Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
  • Monitor prior authorization requests
  • Provide clinical support to internal departments and address clinical related questions
  • Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
  • Develop and implement programs designed to impact DUR for both Medicaid and Medicare
  • Develop, implement, and maintain policies and procedures for the pharmacy department
  • Participate in the coordination of the Medicare MTM program
  • Assist case management team with members including clinical rounds presentations
  
  Story Behind the Need
  • What is the purpose of this team?
  • Describe the surrounding team (team culture, work environment, etc.) & key projects.
  • Do you have any additional upcoming hiring needs or is this request part of a larger hiring initiative? This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business.
  Typical Day in the Role
  • Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
  • What are the performance expectations/metrics?
  • What makes this role unique? A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determiantions
  Candidate Requirements
  Education/Certification Required: Bachelors / PharmD Preferred:
  Licensure Required: Current states pharmacist license Preferred:
  Years of experience required: 1 to 3 years experience
  
  Disqualifiers: None
  
  Additional qualities to look for: Flexibility to work a weekend rotation
  • Top 3 must-have hard skills stack-ranked by importance 1 Clinical decision making
  2 Ability to learn new skills quickly
  3 Adaptability
  Candidate Review & Selection
  • Shortlisting process
  • Candidate review & selection
  • Interview information
  • Onboard process and expectations Projected Manager Candidate Review Date: 1-2 days post shortlisting
  
  Type of Interviews:
  Teams-camera on
  Required Testing or Assessment (by Vendor): NA
  Next Steps
  • Additional background check requirements (List DFPS or other specialty checks here)
  
  • Do you have any upcoming PTO?
  • Colleagues to cc/delegate
  • Are there any training requirements (time off, alternate schedule, etc.)?
  
  

• About the company

  Mindlance is one of the largest diversity-owned staffing firms in the US . As a recruitment centric talent acquisition company, Mindlance provides Technology, Engineering, Digital / Creative / Marketing, Clinical Research, Scientific, Finance, Professional and Payroll Management staffing services to Global 1000 companies across the US, Canada and India.

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