University of Massachusetts Medical School

Consultant Pharmacist IV

University of Massachusetts Medical School • $110K — $130K *
Westborough, MA 01581In-Person
Pharmaceuticals & Biotech
Less than 5 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • Bachelor of Science degree in Pharmacy with 3 years of experience or Doctor of Pharmacy degree with 2 years of pharmacy-related work experience or residency
  • Doctor of Pharmacy with 1 year of residency and 1 year of work experience
  • Doctor of Pharmacy degree with completion of a managed care residency
  • Eligibility for Massachusetts pharmacist licensure in good standing
  • Ability to travel to off-site locations

Responsibilities

  • Provide orientation and training to Consultant Pharmacists and Pharmacy Associates
  • Coordinate prior authorization request processes and ensure compliance
  • Participate in the development of clinical drug use criteria
  • Research member cases for appeal processes regarding prescriptions
  • Conduct comprehensive medication reviews of medical profiles
  • Offer real-time drug therapy recommendations to prescribers
  • Monitor pattern compliance and report suspected abuse cases

Benefits

  • Opportunity for professional development and training
  • Involvement in clinical pharmacy services and quality assurance projects
  • Engagement with an interdisciplinary team including advisory boards
  • Exposure to diverse healthcare environments through provider site visits
Full Job Description
Overview

GENERAL SUMMARY OF POSITION:

Under the general direction of the Manager or Consultant Pharmacist Team Lead or designee, the Consultant Pharmacist IV functions as a team member of the drug utilization review and medication management therapy programs within Clinical Pharmacy Services (CPS). CPS is responsible for administering client-specific programs to provide clinical expertise in regards to prior authorization for member prescriptions and client member's drug therapy. This position will participate in prospective and retrospective DUR activities including, but not limited to: handling live calls from physicians and pharmacists, reviewing appropriate drug therapy, coordinating and managing the request for prior authorization process, and participating in the development of clinical drug use criteria. This position will also be responsible for the orientation, training and indirect supervision of the Consultant Pharmacists and Pharmacy Associates.

Responsibilities

MAJOR RESPONSIBILITIES:
  • Provides orientation, training, guidance and direction, to Consultant Pharmacists and Pharmacy Associates
  • Coordinates the request for prior authorization (RPA) process including the data entry and the generation of reports that stem from this process, as well as ensure compliance with the federal twenty-four hour time limit.
  • Participates in program planning and development.
  • Participates in the development of clinical drug use criteria for the prospective and retrospective review components of the DUR Program.
  • Researches member's case and may represent the client during appeal processes regarding prescription medications.
  • Performs medication therapy management comprehensive and targeted medication reviews of medical and medication profiles
  • Reviews member's medical and medication profiles and interacts with health care providers and client members to review appropriate drug therapy.
  • Provide real-time drug therapy recommendations to prescribers
  • Reviews clinical documentation submitted by treating physicians and pharmacists to determine medical necessity and program compliance.
  • Decides in real time via telephone communications with pharmacies the authorization or denial of prior approval requests for prescription medications.
  • Provides pharmaceutical expertise and knowledge to the advisory board's clinical workgroups.
  • Monitors over-utilization and under-utilization of prescribed medicines for members.
  • Assists in monitoring and researching profiles for compliance on a daily basis.
  • Refers suspected abuse and fraudulent members to the program manager or designee for case review.
  • Participates in site visits to Provider offices, as necessary.
  • Participates in agency meetings as requested.
  • Leads and participates in quality improvement and quality assurance initiatives
  • May perform other job related duties as assigned or requested.


Qualifications

REQUIRED QUALIFICATIONS:
  • Bachelor of Science degree in Pharmacy with 3 years of work experience OR
    • Doctor of Pharmacy degree with 2 years of pharmacy-related work experience or completion of 2 years of pharmacy residency OR
    • Doctor of Pharmacy degree with completion of 1 year of pharmacy residency and 1 year of pharmacy-related work experience OR
    • Doctor of Pharmacy degree with completion of managed care residency program
  • Eligibility for licensure or current pharmacist license in good standing in the Commonwealth of Massachusetts
  • Ability to travel to off-site locations


Additional Information

PREFERRED QUALIFICATIONS:
  • Previous medical and medication review experience
  • Bilingual fluency in reading, writing and speaking English and one other major language

About University of Massachusetts Medical School

The University of Massachusetts Medical School (UMMS) is a world-class research institution with a uniquely collaborative spirit, that consistently produces noteworthy advances in clinical and basic research. The school is located in Worcester, Massachusetts and is part of the University of Massachusetts system. UMMS is dedicated to advancing the health and well-being of the people of the commonwealth and the world through pioneering advances in education, research, and health care delivery. The school is home to three Nobel laureates, 25 research centers, and a faculty of more than 1,200 physicians, scientists, and health care professionals.
Learn more about University of Massachusetts Medical School
Size
6,000 employees
Industry
Education, Government & Non-Profit
Founded
1894
* Ladders Estimates

Similar Jobs

Ad banner background

Get Ready For Your
Next Interview

More Jobs at University of Massachusetts Medical School

More Pharmaceuticals & Biotech Jobs

Find similar Consultant Pharmacist IV jobs:

NationwideWestborough, MA