Clinical Pharmacist Reviewer
Location: , Iowa
Description: Magellan Health Services is currently seeking to employ Clinical Pharmacist Reviewer right now, this job will be reside in Iowa. For complete informations about this job opportunity please read the description below. (
Job Number:
15316
)
Job Summary
This position facilitates Magellan’s efforts in the development of psychopharmacological quality manage! ment programs. The Pharmacist Reviewer supports drug utilization review (DUR) efforts by reviewing physician prescribing patterns, consulting with physicians regarding these patterns using evidence-based best practices, working closely with internal staff in the refinement of Magellan’s psychopharmacology management programs, providing consultation on pharmacy issues to clinical operations representatives and facilitating the successful implementation of these programs for customer organizations. The primary activities of this position will center on discussions with practicing physicians (and other prescribers) to consult on prescribing of behavioral health medications. This will report to the Pharmacy Program Director and will coordinate with operations, clinical, medical, reporting and other internal departments as needed.
Essential Functions
Pharmacy Data Review:
Regularly review and monitor prescription claims data and prescribing practic! es identified as outliers by internal and/or external analysis! of pharmacy claims data.
Consultations/Interventions:
Contact physicians/prescribers identified as needing consultation to provide coaching on prescriptions and prescribing practices that have been identified as outliers. (Most contacts with be in-person visits with the prescribers, though some may be by phone.) Review prior authorizations and determine opportunities for interventions.
Intervention Tracking/Documentation:
Track contact attempts and contacts per operations procedures. Document content of and results of consultations as defined in operations procedures; maintain records as required.
Intervention Refinements:
Collaborate on the refinement of consultation scripting; solicit and utilize input from those contacted toward scripting improvements.
Operations:
A) Contribute to the success of the operations of the pharmacy program by assisting with the implementation and management of bot! h written and verbal communications to physicians/prescribers and maintenance of the edits and data elements that support the edits. B) Be available for consultation on pharmacy-related questions/issues for others within the organization (e.g. health coaches, care managers, etc.).C) Update and maintain program engine, coding, consultation sheets and outreach program as needed.
Quality Improvement:
Contribute to program improvements by using “continuous quality improvement†processes, by being proactive in identifying improvement opportunities and by contributing on-going consultation and collaboration with product leaders.
Medical/Clinical:
Uphold clinical integrity of pharmaceutical solutions by staying up-to-date on medication information, contributing to the identification of pharmacy program best practices, collaborating with Medical Directors/Medical Dept./Clinical Dept. and providing pharmacy expertise within the organizatio! n.
Non-Essential Functions
Other duties as assigned. !
Contribute creative solutions to improve operational efficiency and effectiveness of pharmacy team.
Minimum Requirements
Education: PharmD
Field(s) of study: Board Certified Psychiatric Pharmacy or 5 years equivalent experience needed.
Experience: 5-8 years
Industry: Psychiatric Pharmacy experience needed, Managed pharmacy benefits organizations preferred.
Job Specific: 5 yrs experience in clinical pharmacy with emphasis in psychiatric pharmacy or BCPP certification needed. Experience with pharmaceuticals in a pharmaceutical sales, retail, or managed care environment, including contact with physicians/prescribers preferred. Management experience in the coordination of and collaboration of work teams preferred.
Education and/or experiences may run concurrent.
Other
MH/SA pharmaceutical service experience a plus as is experience with coaching physicians! /prescribers on medication issues, especially on behavioral health medications. Knowledge of current research related to behavioral health medications. Strong research and implementation skills in practical settings. Analytic skills which can translate into practical/pragmatic recommendations. Strong team orientation with respect for all members. Excellent verbal and strong written communications skills. People skills are essential that allow for the successful consultation with physicians, prescribers and pharmacists and for successful collaboration with Magellan employees and external vendors who do not directly report to this position.
Computer Skills: Must be comfortable with using computers and the internet; basic skills with Microsoft office products and ability to quickly learn proprietary systems.
Licenses, Certifications, etc.: Registration as a Pharmacist (within 6 months), BCPP or 5 years equivalent experience.
Preferred Q! ualifications
Education: Managed care, pharmaceutical s! ales management experience preferred.
Primary Location
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IA-WFHIA-WFHIA1
Work Locations
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Work at Home (IA00)
Work at Home
Magellan Health Services is a leading specialty health care management organization with expertise in managing behavioral health, radiology and specialty pharmaceuticals, as well as public sector pharmacy benefits programs. We deliver innovative solutions to make a positive impact on the cost and quality of health care, keeping the best interests of the people we serve at the center of our decision-making. The breadth of our offerings, depth of expertise, clinical excellence and smart, talented employees is what makes us unique.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy a! nd our work environment where we value professional growth and development, total health and wellness, rewards and recognition and employee unity. Magellan is a place where you can thrive.
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If you were eligible to this job, please deliver us your resume, with salary requirements and a resume to Magellan Health Services.
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This job will be opened on: Fri, 19 Apr 2013 16:52:39 GMT
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