Commercial PBM Clinical Pharmacist

<meta><p dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:" basel="" grotesk",arial,sans-serif;margin-right:0px;padding:0px;margin-top:0px;margin-bottom:0px;"=""><b><strong style="font-size:18pt;white-space:pre-wrap;">About the role</strong></b></p><ul data-pattern="discCircleSquare" data-depth="1" style="margin:16px 0px;font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:" basel="" grotesk",arial,sans-serif;padding:0px="" 0px="" 32px;list-style-type:disc;"=""><li dir="ltr" style="margin-top:0px;margin-bottom:0px;color:black;font-size:11pt;--listitem-marker-color:black;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">The Commercial Clinical Review Pharmacist is responsible for the processing and documenting of Utilization Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions) for delegated products and services. The work is detail-oriented, and candidates will be expected to provide sound clinical judgement and communication.</span></li></ul><p dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:" basel="" grotesk",arial,sans-serif;margin-right:0px;padding:0px;margin-top:0px;margin-bottom:0px;"=""><b><strong style="font-size:18pt;white-space:pre-wrap;">What you'll do</strong></b></p><ul data-pattern="discCircleSquare" data-depth="1" style="margin:16px 0px;font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:" basel="" grotesk",arial,sans-serif;padding:0px="" 0px="" 32px;list-style-type:disc;"=""><li dir="ltr" style="margin-top:0px;margin-bottom:0px;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Responsible for the clinical evaluation and determination of client UM requests, which includes consideration of the denial language, as well as the appropriateness of the decision as it pertains to the clinical intent of the individual program criteria.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Collaborate with team members to promote consistency of clinical decisions across the pharmacist team.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Other duties as assigned.</span></li></ul><p dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:" basel="" grotesk",arial,sans-serif;margin-right:0px;padding:0px;margin-top:0px;margin-bottom:0px;"=""><b><strong style="font-size:18pt;white-space:pre-wrap;">Qualifications</strong></b></p><ul data-pattern="discCircleSquare" data-depth="1" style="margin:16px 0px;font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:" basel="" grotesk",arial,sans-serif;padding:0px="" 0px="" 32px;list-style-type:disc;"=""><li dir="ltr" style="margin-top:0px;margin-bottom:0px;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;font-size:11pt;line-height:1.38;"><span style="white-space:pre-wrap;">Current pharmacist license in good standing at local State Board of Pharmacy</span><span style="color:black;white-space:pre-wrap;">.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;color:black;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Confident in making clinical decisions independently.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;color:black;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Ability to prioritize tasks and manage multiple projects simultaneously.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;color:black;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Motivated self-starter who does not require constant direction or feedback to drive results.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;color:black;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Flexibility to evolve in a dynamic working environment.</span></li><li dir="ltr" style="margin-top:0px;margin-bottom:0px;color:black;font-size:11pt;line-height:1.38;"><span style="color:black;white-space:pre-wrap;">Proficient with learning new computer systems and using multiple monitors.</span></li></ul>