Pharmacist

Description: The Clinical Pharmacist conducts collection of appropriate clinical/ medical data needed to perform clinical assessments and/or reviews as per the health plan/employer agreed criteria, including inbound from the coordinator as needed as well as outreach calls to physician offices. *Conducts prospective, concurrent, and/or retrospective review of cases using healthplan/employer agreed upon criteria. *Documentation of required clinical/ medical data that support case decision as required - electronically and/or in written format. *Coordinates timely communication of case decision to physician, healthplan/employer, patient and other healthcare professionals, and internal departments within CVS\Caremark following agreed upon approval & denial management processes. *Generates, reviews and validates reporting related of program results *Participate in implementation of new Specialty Pharmacy Programs with employers and health plans as needed. Implementation includes discussion of existing clinical guidelines, individualization of clinical guidelines, processes and procedures to health plan/employer specifics, and review of denial management processes. *Documentation and validation of client specific processes including communication procedures plan demographics, criteria selection, denial management procedures, and reporting requirements. *Facilitation of documentation of program agreement with client

The duties and responsibilities include but not limited to reviewing and approving prior authorizations, reviewing clinical information, making clinical decisions for appropriateness of therapy for various disease states including oncology, infertility, autoimmune diseases and many others. Clinical experience is desired (hospital or PBM). Strong verbal and written communication skills, above average computer skills, problem resolution and leadership characteristics required.

Pharmacists must be available to work any 8 hour shift between 7:30 AM and 6:30 PM, Monday through Friday.

Pharmacy knowledge; Microsoft Office literacy; Excellent oral and written communication skills; 6 months’ minimum experience preferably in retail, hospital, or managed care setting. Exposure to clinical and analytical problem solving. Pharmacy license is required.

Apply Now and look for Ron Autor! 469-729-5756

All your information will be kept confidential according to EEO guidelines.