Clinical Pharmacist Advisor

🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $115k - $150k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

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.

🏖️ Benefits

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