Clinical Pharmacist Advisor

🕒 Yesterday

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Gainwell Technologies

10,000+ employees

⚕ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance ‱ Human Services ‱ Healthcare

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

‱ Conduct clinical evaluations of medication therapy and review prior authorization requests using PDL criteria ‱ Facilitate peer-to-peer discussions with providers regarding prior authorization decisions ‱ Collaborate with prescribers and internal teams on clinical consultations and targeted interventions ‱ Support call center operations by providing clinical guidance and assisting with provider/member communications ‱ Serve as a subject matter expert for pharmacy-related questions across the organization ‱ Contribute to quality improvement initiatives and program enhancements ‱ Maintain clinical expertise and collaborate with cross-functional teams on pharmacy best practices ‱ Provide input on drug utilization reviews and formulary management ‱ Support Medicaid Drug Rebate Program operations and assist with state pharmacy audits ‱ Deliver training to pharmacy providers and contribute to reporting and administrative activities

🎯 Requirements

‱ Registered Pharmacist with respective State Licensure ‱ PharmD (preferred) or Bachelor of Pharmacy degree ‱ At least 5 years of experience working in a pharmacy setting or pharmacy benefit management system ‱ Knowledge of Medicaid at the state and/or federal level ‱ Knowledge of pharmacy-related aspects of Medicaid ‱ Working knowledge of HIPAA regulations and requirements.

đŸ–ïž Benefits

‱ generous, flexible vacation policy ‱ 401(k) employer match ‱ comprehensive health benefits ‱ educational assistance ‱ leadership and technical development academies

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