Clinical Pharmacist Job in Baltimore, Maryland US
Clinical Pharmacist
Job Description:
POSITION SUMMARY
The Clinical Pharmacist reports directly to and assists the Clinical Pharmacist Team Lead with all applicable pharmacy programs. The Clinical Pharmacist is primarily responsible for doing coverage determinations/formulary exceptions and appeals under Medicare Part D and organization determinations and appeals under Medicare Part B. In addition, the Clinical Pharmacist may be responsible for monitoring, reviewing, reporting and making recommendations to the Clinical Pharmacist Team Lead and Director of Clinical Pharmacy Services regarding formulary management, drug utilization, PBM oversight, and/or CMS guidance related programs/projects. The Clinical Pharmacist will provide educational expertise and support to other departments within the company when required to meet the goals of the organization.
REQUIRED EDUCATION AND EXPERIENCE
Pharmacist, with licensure in Maryland within six months of starting employment.
Doctor of Pharmacy with a pharmacy residency or equivalent clinical experience
Three years of experience in managed care with a strong emphasis on clinical skills.
Proficiency in using database information systems and Microsoft Office Suite.
Ability to research and analyze the medical literature including drug information, disease states and clinical practice guidelines
Excellent verbal and communication skills
Knowledge of Medicare Part D and CMS Requirements
RESPONSIBILITIES INCLUDE
Assists the Clinical Pharmacist Team Lead in assuring efficient and effective operations of the Pharmacy Department.
Sharing the responsibility of maintaining the formulary exceptions and prior authorization processes which includes on-call duty
Effectively participates in and contributes to staff meetings, Pharmacy and Therapeutics Committee meetings and interdepartmental work groups.
Responsible for facilitating all department first-level complaints and/or issues and resolve them when possible, prior to forwarding them to the Clinical Pharmacist Team Lead for resolution.
Identifies areas where systems modifications could result in operational improvements and report those to the Clinical Pharmacist Team Lead.
Participates in innovative solutions and clinical programs designed to meet CMS and/or QA requirements as needed.
Monitors and performs reviews of drug utilization (financial and clinical) and/or other projects as needed and prepares summary reports with recommendations for the Director of Clinical Pharmacy Services and/or Vice President of Pharmacy Services.
Participates and collaborates with the Clinical Pharmacist Team Lead and Director of Clinical Pharmacy Services on implementing CMS regulatory guidance and supporting PBM oversight related projects as needed.
Keeps abreast of current and innovative pharmacy practices.
We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
