Clinical Programs Pharmacist

Clinical Programs Pharmacist - Ventura County, Ca


Adecco Medical is seeking a Clinical Programs Pharmacist in Camarillo, Ca! This is for a full time position, direct hire. You will travel to multiple sites and different locations within Ventura County, and be flexible to work beyond normal business hours as needed.

POSITION SUMMARY
The Clinical Programs Pharmacist will report directly to the Pharmacy Director and will assist in oversight activities related to the pharmacy benefit operations including use of pharmaceuticals, drug preauthorization, pharmacies and pharmacists, and the company's Pharmacy Benefit Manager (PBM); participating as a member of the Pharmacy and Therapeutics Committee; participate in appeals, grievances and complaints regarding pharmacy services, participate in provider education initiatives regarding the pharmacy benefit, analyze individual clinician prescription reports, attend medical education meetings and disease management initiatives including quality endeavors that pertain to the pharmacy benefit.

ESSENTIAL FUNCTIONS
Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Essential Functions Statement(s)

Formulary Management: Assist in all operational aspects of the formulary system including PBM oversight, Provide clinical support as needed; Contribute relevant articles for the Pharmacy Provider Newsletter; Operationalize procedures for appropriate and effective prior authorization; Recommend additions, deletions, preferred drug determinations, therapeutic substitutions and other as needed modifications to the company's formulary with approval of the Director of Pharmacy and present recommendations to the Pharmacy and Therapeutics Committee.

Pharmacy Network Management: Educate the provider network regarding the company's formulary, claims, and benefit procedures; Address providers' pharmacy questions and inquires; Work with the company on all DHCS audits when appropriate; Work with other departments involved in the provision of pharmacy services; Establish policy and procedures and internal processes.

Pharmacy Cost Oversight and Management: Conduct cost analyses of pharmacy utilization; Assist in the development of cost saving programs and implement programs with full documentation of all activities/savings to the company; Develop and review standardized pharmacy utilization reports for internal customers, including drug, physician, patient and pharmacy provider specific analysis; Prepare quarterly reviews of pharmacy costs and utilization for the P&T Committee, and other internal committees as needed; Develop utilization tracking reports; Assist in the develop of a program for managing specialty drugs; Participate in the oversight of the PBM, including analysis of performance and reviews; Participate in all PBM reviews. Review interrater reliability reviews conducted by the PBM on their pharmacist.

Drug Utilization Review: Conduct drug utilization review; Assist in the development of over and under-utilization review products and identify and conduct member and provider interventions; Prepare quarterly reviews of drug utilization for the P&T Committee and the Utilization Management Committee.

Support for Staff: Provide training to the staff regarding issues relative to pharmacy operations; Participate in special projects and assignments as needed and other duties as assigned.

POSITION QUALIFICATIONS
Competency Statement(s)

Management Skills - Ability to organize and direct oneself and effectively supervise others.

Business Acumen - Ability to grasp and understand business concepts and issues.

Communication, Written - Ability to communicate in writing clearly and concisely.

Communication, Oral - Ability to communicate effectively with others using the spoken word.

Customer Oriented - Ability to take care of the customers’ needs while following company procedures.

Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.

SKILLS & ABILITIES

Education:
High School Graduate or General Education Degree (GED): Required
Bachelor's Degree (four year college or technical school) Preferred, Field of Study: Business, Health Care Management, and other related fields.
This position requires a professional degree in Pharmacy with a California license in good standing.

Experience:
3 plus years of experience in a health plan or a pharmacy benefits manager (PBM) or successful completion of a manager care residency at a health plan or PBM
Must have Managed Care experience.
Computer Skills:
Advanced computer skills included in the MS Office products.
Certifications & Licenses:
Current California (RPh) license in good standing.
Other Requirements:
Must possess knowledge of the principles of pharmacoeconomics, as well as drug utilization, current medical practice standards and appropriate medication usage; ability to work with multiple software computer programs in the development of pharmacy reports; ability to communicate effectively, both orally and in writing; ability to maintain accurate records; basic knowledge of the Medi-Cal program.
Bi-lingual in English is Spanish is preferred.

PHYSICAL DEMANDS
N (Not Applicable)
Activity is not applicable to this position.
O (Occasionally)
Position requires this activity up to 33% of the time (0 - 2.5+ hrs/day)
F (Frequently)
Position requires this activity from 33% - 66% of the time (2.5 - 5.5+ hrs/day)
C (Constantly)
Position requires this activity more than 66% of the time (5.5+ hrs/day)
Physical Demands
Lift/Carry
Stand
F
Walk
F
Sit
O
Manually Manipulate
O
Reach Outward
O
Reach Above Shoulder
O
Climb
O
Crawl
N
Squat or Kneel
O
Bend
O
Grasp
O
Speak
F
10 lbs or less
F
11-20 lbs
F
21-50 lbs
O
51-100 lbs
N
Over 100 lbs
N
Push/Pull
12 lbs or less
F
13-25 lbs
F
26-40 lbs
O
41-100 lbs
N
Other Physical Requirements

Vision (Near, Distance, Color, Peripheral)

WORK ENVIRONMENT
Office environment.

If you are interesting in applying for this position, please contact Karwan Kallash at: karwan.kallash@adeccona.com
Looking forward to hearing from you soon!

  • Apply with Adecco

Reference number US_EN_2_108175_331666