- Review all prior authorization for medication requests.
- Review records to determine the appropriateness of medication therapy.
- Develop effective medication plans that minimize the risk of adverse side-effects.
- Keep accurate documentation of medication plans and progress.
- Develop clinical criteria and polices for the review of medications.
- Ensure all clinical criteria is in compliance with the Center of Medicare, Medicaid Services and the New York State Department of Health.
- Calculate appropriate billable units based on dosing, weight, BMI and other clinical considerations.
- Ensure compliance with all company policies and procedures and federal and state laws.
- Responsible to stay up to date on current research and information related to medications.
- Collaborate with other healthcare professionals to plan, monitor, review, or evaluate the quality or effectiveness of drugs or drug regimens, providing advice on drug applications or characteristics.
- Complete Utilization Management reviews as needed by the department.
- Other duties as assigned.
- A minimum of 1-2+ years of relevant pharmacy work experience.
- Must live in New York.
- Must be licensed in the state of New York.
- Must be a registered and licensed Pharmacist in good standing with the state of operations.
- Degree in Pharmacy/Pharmacology from an accredited school.
- Solid knowledge of drug administration and health & safety guidelines.
- Team player with outstanding communication skills (verbal and written).
- Work experience conducting prior authorization reviews.
- Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits.
- Knowledge of regulations of the Centers for Medicare and Medicaid Services including but not limited to National and Local Coverage Determinations.
- You have a strong passion for helping people with all pharmacy-related problems.
- PGY1 Managed Care Residency (Preferred).
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Clinical Pharmacist - New York, United States - 4 Corner Resources
Description
4 Corner Resources is looking for a Clinical Pharmacist for one of our clients in the healthcare industry. This candidate would be responsible for the review of prior authorizations, medication adherence, developing clinical criteria, and reviewing monthly reports for quality assurance purposes. If you have strong attention to detail and have a desire to work with patients to keep them safe, then apply todayThis is a contract slated till August with an opportunity for extension.
This is fully remote but you MUST live and have an active Pharmacist License in New York.
Clinical Pharmacist Responsibilities:
$50 / HR based on experience.
