Clinical Pharmacist, Clinical Services

WellCare Health Plans, Inc   •  

Phoenix, AZ

Industry: Healthcare


Not Specified years

Posted 40 days ago

This job is no longer available.

Essential Functions:Provides clinical services to enrolled members in assigned lines of business. May includes counseling patients and offering recommendations to physicians regarding medication-related problems. Examples clinical services include: Comprehensive Medication Reviews (CMR), targeted-medication related problem notifications, adherence programs, member and/or physician related communications (i.e. educational newsletters), drug utlilization review analysis, P&T monographs, drug information requests, prior authorization processing, particpation in appeals case review.Accurately document and records services/activities in appropriate databases/software to ensure compliance with CMS requirements for clinical service offerings assigned in designated area (i.e. Medication Therapy Management services, Quality Improvement Projects, Drug Exception Review, etc.)Supervises technicians/coordinators in regards to compliance, productivity and quality assurance goals by monitoring the daily actions of each associate to ensure that departmental policies and procedures are applied to services provided the department.Provides call center supervision including (but not limited to) decisions made by associate in regards to unit's roles and responsibilities, monitoring of inbound and outbound call volume, service level, and average call handle time (if applicable). Handles escalated member calls related to questions or concerns about drug therapy and/or clinical servicesProvides clinical pharmacy services for the health plan including, but not limited to Pharmacy Operations, Pharmacy Formulary, Pharmacy Quality and Utilization ManagementAssists in development and execution of department standard operating procedures, step action plans/workflows, training materials, and other documents as requiredProvides clinical instruction to pharmacy students/pharmacy residents as assigned to clinical areaPerforms other duties as assignedEducation LevelEducation DetailsRequired/PreferredA Bachelor's Degree inPharmacyRequiredA Doctor of Pharmacy (PharmD)PharmacyPreferredor equivalent work experiencePGY-1 Residency Program completionPreferred
Work ExperienceState the minimum required for the jobExperience LevelExperience DetailsRequired/Preferred1 year of experience inDrug therapy management activitiesRequired1 year of experience inSupervision of techniciansRequired1 year of experience inExposure to managed care (student rotations acceptable).Required
Licenses and CertificationsList professional licenses and certifications associated with this jobLicenses/CertificationsOther Licenses/CertificationsRequired/PreferredOtherLicensed pharmacist in state of operationRequiredOtherBoard Certification (i.e. BCPS) or other designations (i.e. CGP)Preferred
SkillsState the minimum required for the jobSkill SetsOther SkillsProficiencyDemonstrated interpersonal/verbal communication skills
AdvancedDemonstrated written communication skills
IntermediateAbility to influence internal and external constituents
IntermediateOtherAbility to evaluate information from both oral and written sources and develops clear, concise and crisp reports.IntermediateOtherAbility to use pharmaceutical/medical literature to provide drug information to the health plan, patients, and prescribers.Intermediate
TechnologyList technical skills associated with the jobTechnologyOther TechnologyProficiencyRequired/PreferredMicrosoft Excel
IntermediateRequiredMicrosoft Word
IntermediateRequiredMicrosoft PowerPoint
IntermediateRequiredMicrosoft Outlook
IntermediateRequiredHealthcare Management Systems (Generic)