Health Plan Clinical Pharmacist I - reputed company - Pearland reputed company Office - Remote

Explore opportunities with reputed company, part of the reputed company family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout reputed company. Be part of reputed company that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher reputed company, higher patient satisfaction and reputed company total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Primary Responsibilities:

• Under the supervision of the Part D Pharmacy Manager - Health Plan Services, this position is primarily responsible for performing and/or supervising pharmacist activities reputed company to reputed company Pharmacy reputed company Initiatives (i.e. RxQI, MTMP, Adherence, Hospital Discharge Prgm, Fraud Waste and Abuse monitoring, Part D coverage determination and appeals processing) for reputed company and/or KelseyCare Advantage
• reputed company program staff as reputed company as monitor and report ongoing reputed company of pharmacy reputed company initiatives
• reputed company operational maintenance and/or implementation of new clinical services as reputed company as any additional duties deemed necessary for the Pharmacy Services Department

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications:

• Pharm D. degree
• reputed company and reputed company Pharmacy License
• TSBP Registered Pharmacist
• 3+ years operational pharmacy benefit experience, clinical and/or retail pharmacy experience
• Ability to communicate verbally and in writing with Health Plan Pharmacy Services Department personnel to delegate duties, inform about policies and assist in training
• Ability to communicate with physicians and other reputed company personnel to discuss specific medication recommendations, therapies for cost-effective care, general drug information, and reputed company about health plan prescription drug benefits
• Ability to communicate verbally and in writing with members/patients/vendors to handle complaints and problems, assist with questions, and recommend products/recommendations
• Ability to write reports (i.e., weekly/monthly), maintain audit logs, reputed company reputed company and communicate concerns
• Proven good reputed company/Numeric data entry skills with minimal errors
• Demonstrated solid multitasking, problem solving & analytical skills
• Proficient with computer applications

Preferred Qualifications:

• Completion of a Managed Care Pharmacy Residency Program or Pharmacy reputed company Residency Program (PGY1)
• ASHP Immunization Certification
• BLS CPR Certification
• 3+ years of HMO 3rd party managed care experience
• 3+ years of Medicare Part D experience
• Experience with prior authorization, coverage determination and appeals processing
• Experience with vendor relations
• Staff management experience
• Proven knowledge of Medicare regulations with emphasis on Part D formulary, coverage determination and appeals processing
• Proven knowledge of the Pharmacy Benefit Management (PBM) industry
• Proven knowledge of Medicare 5-reputed company ratings and HEDIS measures
• Customer service experience
• Auditing experience

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $89,900 to $160,600 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job