Utilization Management Pharmacist Trainer

Judi Health

$135K — $145K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Doctor of Pharmacy (Pharm.D.) or Bachelor of Pharmacy degree from accredited program
  • Active unrestrictive pharmacist license
  • 3+ years experience as a clinical pharmacist in Pharmacy Benefit Management (PBM)
  • Prior training program development and delivery experience
  • Strong understanding of prior authorization operations and relevant laws
  • Excellent written communication and presentation skills
  • Proven analytical skills and attention to detail

Responsibilities

  • Facilitate onboarding and training for pharmacists on prior authorization systems
  • Develop and update comprehensive training materials and job aids
  • Ensure training content is clinically relevant and compliant with regulations
  • Maintain records of training sessions and participation for audits
  • Assess pharmacist performance and provide constructive feedback
  • Collaborate with pharmacy management to identify training needs
  • Make clinical determinations on prior authorization cases
  • Document prior authorization cases and communicate with stakeholders

Benefits

  • Flexible schedule with remote work options
  • Supportive work environment with a focus on professional development
  • Opportunity to shape training programs with impactful content
  • Exposure to cross-functional collaboration within healthcare
  • Engagement with a dynamic team in a high-volume setting
Full Job Description
Position Summary:
We are seeking a dynamic and experienced pharmacist trainer to join our team. As a pharmacist Trainer, you will play a pivotal role in developing and delivering training programs that enhance knowledge, operational efficiency, and customer service skills to our pharmacist staff. The successful candidate will have a strong background in pharmacy practice, a passion for education and the ability to create engaging and impactful training content.

Position Responsibilities:
• Facilitate the onboarding process for new hires and provide comprehensive training sessions for pharmacists on prior authorization systems, processes, and procedures utilizing a variety of training methods.
• Develop and update training materials, resources, verbiage templates, job aids, and communicate updates to the team.
• Ensure that training content is accurate, up-to-date, clinically relevant, compliant with federal and state regulations, and internal policies.
• Maintain detailed records of training sessions, participant attendance, and training materials for auditing and reporting purposes.
• Assess performance of pharmacists through evaluations, quizzes, and practical assessment to identify areas for improvement and provide constructive feedback.
• Collaborate with pharmacy managers, supervisors, and other relevant stakeholders to identify training needs, performance gaps and ensure alignment with company goals.
• Make clinical prior authorization and appeals determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times.
• Provide detailed and thorough documentation in prior authorization cases, overrides and call center cases.
• Perform peer-to-peer reviews with providers when requested.
• Perform scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to providers.
• Effectively communicate issues and resolutions to members, pharmacies, providers, and appropriate internal stakeholders.
• Provide backup support to call center team as required.

Required Qualifications:
• A Doctor of Pharmacy (Pharm.D.) degree or Bachelor of Pharmacy degree from an accredited pharmacy program.
• An active unrestrictive pharmacist license.
• 3+ years of experience as a clinical pharmacist in Pharmacy Benefit Management (PBM) setting.
• Previous experience developing and delivering training programs.
• Solid understanding of prior authorization operations, Federal and State laws, and regulations.
• Excellent written communication and presentation skills to effectively convey complex information to diverse audiences.
• Excellent analytical skills and attention to detail.
• Ability to collaborate effectively with cross-functional teams and adapt to changing priorities.
• Proficiency in using e-learning platforms, multimedia tools, and Microsoft Office Suite.
• Ability to work a flexible schedule independently with minimal supervision, staying productive in a remote, high-volume, and metric driven call center environment.

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

New York, NY Salary Range

$135,000-$145,000 USD

Denver, CO Salary Range

$135,000-$145,000 USD

Charlotte, NC Salary Range

$135,000-$145,000 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

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