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?
- What is driving this need? (ex. Backfill for FTE or CW, new project, business growth)
- 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?
We provide medication reviews for members that have qualified for one of our pharmacy clinical programs. Currently we have a clinical program expanding and need additional support temporarily. No further hiring needs.
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 performance expectations/metrics?
- What makes this role unique?
Pharmacist will be expected to review a patient’s medical information and pharmacy claims for gaps in care, drug therapy problems, etc. Expectation is 90% productivity daily.
Candidate Requirements
Education/Certification
Required: B.S. in Pharmacy or PharmD
Preferred:
Licensure
Required: required to be licensed in state of residence
Preferred:
Years of experience required: at least 2 years MTM experience
Disqualifiers: Not having MTM experience
Additional qualities to look for:NA
- Top 3 must-have hard skills stack-ranked by importance
1
Work independently
2
Critical thinking
3
Clinical skill
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
Required Testing or Assessment (by Vendor):
na
Next Steps
- Do you have any upcoming PTO?
No
- Colleagues to cc/delegate
None
