Clinical Pharmacist - Remote Job at Get It - Healthcare, Honolulu, HI

cnpBYUtCVHNpMjh2SSs0bmVreVk2TGlXVEE9PQ==
  • Get It - Healthcare
  • Honolulu, HI

Job Description

Position Overview:

Are you ready to make a difference in the lives of millions of individuals? Join a dedicated team focused on improving healthcare outcomes for Medicaid members as a Clinical Pharmacist. This fully remote position is based in Hawaii, and you'll have the flexibility to work from home while playing a key role in managing drug therapy for members of a Medicaid health plan. As a Clinical Pharmacist, you'll make important decisions about drug utilization, manage prior authorization requests, and contribute to health plan initiatives that help ensure our members receive the best care possible.

Key Responsibilities:

Review and assess prior authorization requests, making informed determinations on drug products based on member benefits and coverage criteria.
Develop and implement criteria for medication analysis, ensuring adherence to regulatory requirements for drug utilization reviews, fraud, and abuse reporting.
Create and recommend clinical criteria for non-formulary and non-preferred medications, providing expert guidance to clients.
Oversee the drug utilization review and medication therapy management programs, ensuring compliance with Medicare Part D and contributing to strategic initiatives.
Develop and implement clinical edits to improve drug utilization at the point of sale, using evidence-based practices.
Offer support and clinical guidance to pharmacy technicians, ensuring high-quality work and continuous learning.
Review and develop guidelines for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committees and pharmacy benefit design.
Evaluate pharmacy practices and implement opportunities for performance improvement to ensure quality control and optimal member outcomes.
Stay up to date on drug information and disease state knowledge to maintain clinical expertise for prior authorization reviews.
Perform other duties as assigned and adhere to company policies and standards.
Qualifications:

A Bachelor's degree or advanced degree (PharmD, M.S.) in pharmacy.
At least 3 years of experience in retail or hospital pharmacy, or 1 year of experience in managed care pharmacy.
Clinical pharmacy experience in managed healthcare is preferred.
Active, unrestricted Pharmacist license in Hawaii (additional state licenses may be required based on location or contractual needs).
Preferred Qualifications:

Comfortable using various technologies or willing to learn new systems.
Familiarity with Hawaii health plan rules and regulations.
Experience in Prior Authorization and Utilization Management, specifically in pharmacy and medical pharmacy.
Ability to thrive under pressure in a small team environment, serving as the go-to person for many requests.
Compensation:

The annual salary range for this position is $103,500 - $191,600, depending on experience and qualifications.
If you're looking for an opportunity to apply your pharmacy expertise while making a meaningful impact in healthcare, we'd love to hear from you!
Employment Type: Full-Time
Salary: $ 103,500.00 191,600.00 Per Year

Job Tags

Full time, Remote job, Work from home,

Similar Jobs

Aura Staffing Partners

Surgical Tech Job at Aura Staffing Partners

Position: Per Diem Surgical Technologist Location: Colorado Springs Area Pay Rate: Up to $36 per hour (based on experience) Job Description: We are looking for a dedicated Per Diem...  ...: Current Colorado Surgical Tech license in good standing. Previous... 

University of California Riverside

Assistant Professor in Plant Systems Biology or Biotechnology | University of California Riverside Job at University of California Riverside

 ...Assistant Professor in Plant Systems Biology or Biotechnology University of California Riverside The Department of Botany and Plant Sciences at the University of California, Riverside seeks applicants for a tenure-track faculty position at the Assistant level focusing... 

Always Best Care Senior Services - Morris, NJ

Home Care Field Nurse (RN) -- per diem Job at Always Best Care Senior Services - Morris, NJ

We are seeking a part-time Registered Nurse (RN) to join our dedicated home care team. Our private-duty agency provides personal care...  ...observe their performance every 3 months.* Maintain documentation per New Jersey Board of Nursing/NJ Division of Consumer Affairs... 

AVA Search Group

Radiation Therapist Job at AVA Search Group

Radiation Therapist - Southern, Texas Competitive salary and benefits including a sign on bonus (2 year commitment) and relocation assistance...  ..., 1 year of experience, Graduate of an accredited radiation therapy school, Texas licensed, Bilingual in Spanish preferred. Area... 

Fairfield Medical Center

Travel Radiation Therapy Job Job at Fairfield Medical Center

Embark on an exciting opportunity as a Radiation Therapist in Radiation Therapy, based in the beautiful state of Ohio, specifically in Lancaster. This role allows you to make a difference in the lives of patients by providing vital radiation therapy treatments. Working...