Gainwell Technologies
10,000+ employees
💼 Consulting
📦 Logistics
⚕️ Healthcare Insurance
💰 Grant on 2023-06
Consulting • Logistics • Healthcare Insurance
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.
Clinical Pharmacist Advisor
🕒 June 26
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Gainwell Technologies
10,000+ employees
💼 Consulting
📦 Logistics
⚕️ Healthcare Insurance
💰 Grant on 2023-06
Consulting • Logistics • Healthcare Insurance
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 • Contribute to reporting and administrative activities • Operate the Medicaid prescription drug program within state budget and legislative requirements and laws
🎯 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
• Flexible hours • Work-life balance • Continuous learning • Career development • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Travel expense reimbursement and benefits as applicable
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