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Utilization Management- 26337-1 MPK
Monterey Park, California | Contract
EXCITING 1 YEAR CONTRACT FOR UTILITZATION MANAGER IN MONTEREY PARK!
RN JOB DESCRIPTION (Drug Utilization Review (DUR) Pharmacist)
This position is primarily responsible for supporting the Pharmacy and Therapeutics (P&T) Committee process, and supports the clinical components of the Pharmacy Services Benefit Management Drug Authorization Program by ensuring that evidence based clinical decisions of the company Pharmacy and Therapeutics Committee are implemented operationally in order to provide a quality, cost effective pharmacy benefit.
- Support the operational and clinical implementation of medication policies for drugs in the pharmacy benefit, for both Medicare and Medi-Cal lines of business.
- Provide pharmacist support for the drug prior authorization program by providing clinical expertise to Prior Authorization technician team to ensure review of prior authorization requests
- within all regulatory required time frames.
- Ensure compliance with various regulatory and quality accreditation requirements around drug utilization management in order to support safe, efficacious, and cost-effective prescribing.
- Provide pharmacotherapy expertise for the pharmacy program by supporting the Pharmacy and Therapeutics Committee, drug formulary, prior authorization, drug utilization review and
- physician reporting programs.
- Serves as an educational resource to internal and external constituents regarding the company drug formulary, medication policies and appropriate drug use.
- Provides support for the development and maintenance of an internal company Drug Formulary for all product lines.
- Pharm. D. degree in Pharmacy and two years of experience in clinical pharmacy, or equivalent combination of education and experience, plus current and unrestricted/clear California Pharmacy License
- Prior experience in a managed care/PBM setting is preferable.
- Thorough clinical knowledge regarding therapeutic use of drugs.
- Excellent oral and written communication skills.
- Proficient with computers and related software applications.