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Clinical Pharmacist/Algorithms- REMOTE

extra holidays - extra parental leave
Remote: 
Full Remote
Contract: 
Full time
Salary: 
98 - 166K yearly
Experience: 
Mid-level (2-5 years)
Work from: 
United States

Offer summary

Qualifications:

Current RPH license required, Bachelor's in Pharmacy required, PharmD preferred, Strong clinical pharmacy knowledge, Experience in pharmacy required.

Key responsabilities:

  • Perform drug utilization reviews and appeals
  • Provide prior-authorization services
  • Collaborate on treatment guidelines
  • Maintain compliance with laws and standards
  • Assist in outpatient care calls
Prime Therapeutics logo
Prime Therapeutics Insurance Large https://www.primetherapeutics.com/
1001 - 5000 Employees
About Prime Therapeutics
Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 24 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Prime’s recruiting team will only contact you via phone call or through a corporate email address. Do not respond to suspicious emails or social media messages. If you have questions or are skeptical about any follow-up communications, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.
See more Prime Therapeutics offers

Job description

Our work matters. We help people get the medicine they need to feel better and live well.  We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Clinical Pharmacist/Algorithms- REMOTE

Job Description Summary

Performs prospective and/or retrospective drug utilization review and appeals per State and Federal regulations. Participates in the distribution of clinical drug information and educates providers and staff regarding the use of pharmaceutical treatment regimens. Complies with all corporate and facility standard operating procedures, policies, guidelines, and work instructions.

Job Description

  • Provides prior-authorization services for formulary drugs, develops programs to provide optimal pharmacy care to patients, participates in drug utilization review programs, reviews assessment and documentation of patient care, and retrospective reviews of provider reimbursement.  Makes recommendations to physicians and other prescribers on medication regimens as per plan guidelines. Assists providers to ensure accurate dispensing and billing of products.
  • Collaborates with other clinical personnel in assessing treatment guidelines. May participate in formulary development and management. Supports the national Pharmacy and Therapeutics Committee. Validates the clinical availability of multi-source products for provider utilization.
  • Adheres to organizational policies and procedures. Ensures compliance with Federal and State laws and standards of practice which govern the profession of pharmacy. Maintains pharmacy records in accordance with all applicable state and federal laws and regulations. Maintains clinical skills and knowledge of pharmacotherapy by reviewing the literature, continuing education and any company provided in-services. Completes all mandatory company provided on-line courses. Attends and completes all employee development courses.
  • Participates in mandatory on-call rotation when required by business needs.  
  • Makes outbound or takes inbound telephone calls to assist in various aspects of patient care and/or product distribution to/from practitioners, members, and pharmacies. These calls include, but are not limited to, comprehensive medication reviews, targeted medication reviews, call to practitioners about product awareness, and prior authorizations.

Responsibilities

Strong drug product and clinical pharmacy knowledge.License must be current and in good standing.

Work Experience

Work Experience - Required:

Pharmacy

Work Experience - Preferred:

Education

Education - Required:

Bachelors - Pharmacy

Education - Preferred:

PharmD - Pharmacy

Certifications

Certifications - Required:

RPH - Registered Pharmacist - Pharmacy - Pharmacy

Certifications - Preferred:

PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy - Pharmacy

Potential pay for this position ranges from $97,760.00 - $166,180.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. 

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Pharmacy RecordsClinical PharmacyDrug ProtocolsPharmacy LawDrug Utilization ReviewPatient Needs AssessmentContinuing Medical EducationOutbound TransactionsMedication Administration

Other Skills

  • Detail Oriented
  • Analytical Thinking
  • Problem Solving
  • Verbal Communication Skills
  • Collaboration
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