In this role, you will develop clinical criteria for review of medications, recommend plan design changes and communicate recommendations to clients. Monitor and review prior authorization requests for medications.
In this role, you will coordinate the activities of assigned pharmacy technicians engaged in the preparation, labeling and delivery of medications and other pharmaceutical supplies in accordance with provider's prescriptions.
The Clinical Pharmacist/Clinical Pharmacy Analyst requires a clinical pharmacy and data analytic background to leverage integrated pharmacy and medical data help identify members who meet prior authorization criteria for select drugs (e.g. criteria based on age, diagnosis, prior use select drugs, etc.) so that the prior authorization can be granted for the member without impacting the member and provider experience at the pharmacy (AKA Smart Edits).