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.
Prior Authorization Pharmacist
🕒 June 8
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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
• Evaluate drug and drug class reviews following evidence-based research and processes widely accepted by the medical community • Show your expertise by monitoring prescription claims data seen as exceptions to develop relevant retrospective drug utilization review (DUR) initiatives; present them to leadership • Enhance your knowledge in this area by consulting physicians and prescribers identified as outliers, tracking contact attempts and documenting consultation results • Help write consultation and intervention scripts to support continuous improvement and quality improvement processes • Maintain up-to-date knowledge of medications, drugs and prescribing practices; advise Gainwell leaders based on your knowledge and expertise • Assist Gainwell leadership in reviewing clinical criteria and Preferred Drug List (PDL) recommendations used to make coverage and PDL placement decisions
🎯 Requirements
• 5 or more years of experience in a clinical pharmacy setting, with managed care pharmaceutical service experience a plus • Knowledge of current research and best practices relating to specialty medications • Analytical and research expertise to conduct drug class and clinical reviews involving prescribing behavior to reach pragmatic conclusions • Strong written, oral and clinical communication skills to collaborate with physicians, prescribers, pharmacists and Gainwell leadership • A caring people leader who understands their role on a team and can effectively delegate tasks
🏖️ Benefits
• Opportunities to travel through your work (0-10%)
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