Pharmacist Clinical Manager Job Listing at The Judge Group in United States of America
Job ID: 377277
Job Title: Pharmacist Clinical Manager
Job Type: Contract
Company: JUDGE GROUP
Location: Franklin Lakes NJ
Contact E-mail: firstname.lastname@example.org
Qualifications: Required Skills and Attributes:
* B.S. Degree in Pharmacy with Licensure
* Excellent relationship building, reporting, and analytical skills
* Strong communication skills a verbal, written and presentation; comfortable with interaction with all levels of the organization
* Ability to successfully manage multiple initiatives at the same time
* Self-motivated with strong initiative skills
* Proficient in MS Word, Excel, and Access.
* Strong team building / motivation / influencing and leadership skills
* Extremely flexible and adaptable to changing priorities and assignments
* Self-starter with a desire to learn
* Comfort leading cross-functional partners with varying levels of experience and skill sets
* Demonstrated leadership and project management skills
Drug Coverage for commercial prescription benefits
* Clinical consultative services to Clinical Account Executives and Account Management staff, Clinical and Specialty Pharmacy Product Owner.
* Analyze drug coverage or drug lists requirements for clinical and operational appropriateness and content.
* Provide drug benefit coverage recommendations and drug benefit requirements based upon client intent and operational functionality of Medcoas clinical systems
* Evaluate clinical service requests for potential negative impact on the overall benefit design. The evaluation will identify and resolve potential conflicts within the prescription benefit design, ensuring the synchronization with products such as Specialty Pharmacy, RRA (Mail Service marketing programs) and retail pharmacy restrictive distribution programs.
* Understand PBM benefit as a whole to ensure the appropriateness of the drug coverage benefit component.
* Analyze existing coverage to determine clinical completeness of benefit.
* Facilitate the configuration of Coverage Authorization clinical rules across large numbers of drug plans.
* Facilitate data queries of the Drug Coverage databases and analyze plan coverage for products such as Coverage Authorization and Specialty Pharmacy
* Identify conflicts between clinical edits and provide drug coverage recommendations to resolve the conflicts.
Drug Coverage for Medicare Part D drug benefits
* Analyze custom client MedicareaD drug benefits for impact based on changes in CMS guidelines and provide recommendations to affected Clinical Account Executives regarding required drug coverage changes.
* Maintain Medicare B / D coverage overlap drug lists and MedicareaD only drug lists and coverage.
* Configure Medicare-D temporary coverage override (TCO) benefit designs and provide installation instructions to Account Management.
Specialty Pharmacy, pricing, copay and benefit cap drug list administration
* Provide consultative services and configuration services for the enrollment in Medco / Accredo specialty pharmacy and retail specialty pharmacy benefit drug coverage.
* Perform intake assessment, requirements documentation and configuration of Specialty Pharmacy pricing drug lists
* Perform intake assessment, requirements documentation and configuration of Copay, Pricing and Benefit Cap drug lists.
First Data Bank Clinical Highlights and Clinical Updates a drug coverage impact assessment and maintenance
* Analysis of Clinical Highlights sent from First Databank Corporation, announcing new medications and reclassification of existing drugs.
* Upon reviewing the information for each new medication or reclassification, perform an impact assessment to drug coverage, clinical products, Medicare and Specialty Pharmacy.
* Communicate drug benefit recommendations to address the impact of the drug database changes to select clients and product managers
* Analysis will indicate how this new information may effect current plan coding.
* Performing query scans of impacted coding elements based on clinical and professional judgment and existing coding knowledge.
* Perform a quality cont
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