Pharmacist - Prior Authorization Clinical Specialist:
MedImpact Healthcare System

1189032184
MedImpact Healthcare System
Pharmaceutical
Apply
Description
Clinical Specialist - Part Time MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! The Scoop: The Clinical Specialist manages accessibility, quality, and cost-effectiveness of drug and medical therapy for members and providers. This position focuses on initiating, supporting, and continuing cost-effective, rational drug, and disease therapy, utilizing distinct but inter-related management and cross-departmental functions. What You Get To Do: Responsible for providing clinical support services to client plan(s) contracting for clinical services Support services will include, but not limited to, clinical review, analysis, recommendation, decision and documentation of prior authorization requests, medical exception requests, and appeal requests as required by client contracts and Utilization Management delegation agreements Review medication request guidelines for clinical appropriateness and operational efficiency Assist in the revision and creation of new or existing medication request guidelines as indicated Provide drug information support Research and provide clinical literature documentation to support prior authorization decisions as indicated May include preparation of Pharmacy and Therapeutics meeting agenda and associated meeting materials including clinical and financial reviews of individual drugs, drug classes, and current therapy for specific disease states and drug formulary review Coordinate and assist in the preparation of utilization and compliance reporting for client plans Ensure timely preparation and review of plan data and client presentations, when required Coordinate and assist with projects associated with prior authorization program development, implementation and internal and external communications Provide feedback to Prior Authorization Coordinators (PACs) regarding the processing of PA cases referred for clinical review Provide in-service education to PACs regarding topics such as PA guidelines, diagnoses commonly seen as part of the PA review process Education and/or Experience For consideration candidates will need a Pharmacy degree (Pharm. D.) or equivalent And two (2) to five (5) plus years related experience and/or training Or equivalent combination of education and experience Computer Skills To perform this job successfully, an individual should have knowledge of Microsoft Office Suite Word Processing software. Certificates, Licenses, Registrations Current, unrestricted Registered Pharmacist license in the State of Kentucky. Other Skills and Abilities Excellent working knowledge of all types of pharmacy services with an emphasis on the managed health care environment Expertise in clinical application of pharmacy practice The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus This position is eligible for Employee Referral Bonus at Level IV To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. EOE, M/F/D/V OSHA/ADA: To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.