113 Pharmaceutical jobs

Position Purpose: Coordinate and assist in managing and participating in pharmacy services including quality assurance and clinical monitoring activities. Participate in decisions regarding the pharmaceutical services within assigned scope including: Assessing the patient's general pharmaceutical needs Planning for the pharmaceutical services provision Participating in the overall plan of care Participating in the overall quality assessment and improvement plan Receive physician prescription orders and evaluate the appropriateness of these orders for dosage, drug choice, potential drug interactions, route of administration and stability Review the patient chart for allergies, current and past medical history, clinical laboratory results and concurrent medications Provide patient counseling, education, and monitoring Provide clinical interventions Assess responses to therapy, patient compliance, and ongoing review of drug regimens; report and manage adverse events...

Provide timely drug therapy for Medicaid health plan members by processing prior authorization and medical necessity request Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria Responsible for setting criteria for medication analysis, coordinate reports to clients, meet regulatory reporting requirements for drug utilization review and fraud and abuse reporting Develop clinical criteria for review of non-formulary or non-preferred drug lists medications and communicate recommendations to clients Oversee the drug utilization review and medication therapy management programs at the assigned plan to meet Medicare Part D requirements and develop systematic reviews of prescription claims to meet strategic initiatives Develop clinical edits effective at the point of sale to enhance appropriate drug utilization based on evidence-based criteria Provide clinical guidance and support to the assigned pharmacy...

Position Purpose: The Clinical Pharmacist processes review prior authorization requests for biopharmacy medications for clinical appropriateness. This assures members receive the most effective and cost effective pharmacological therapies. Reviews a completed prior authorization request received from the provider and/or reviews the pharmacy technician's recommended denial, suggested formulary alternatives, comments and attachments for appropriateness. Checks for previous prior authorization decisions. Verifies coverage in member's prescription benefit when necessary. Verifies coverage in member's health plan benefit when necessary. Evaluates prescription claim history. Reviews chart notes and/or lab values. Identifies provider specialty when appropriate. Applies Medical Policy Criteria to prior authorization requests. Evaluates whether request meets criteria for approval. Reviews the request using professional clinical judgment on a case by case basis. A pharmacist will...

Position Purpose: Coordinate and assist in managing and participating in pharmacy services, including compounding and dispensing of medications, quality assurance and clinical monitoring activities. Participate in decisions regarding the pharmaceutical services within assigned scope including: o Assessing the patient's general pharmaceutical needs o Planning for the pharmaceutical services provision o Participating in the overall plan of care o Participating in the overall quality assessment and improvement plan Receive physician prescription orders and evaluate the appropriateness of these orders for dosage, drug choice, potential drug interactions, route of administration and stability Supervise the filling, receiving, compounding, and dispensing activities involved in providing finished product to the patient Ensure that the patient chart is complete for allergies, height, weight, current and past medical history, clinical laboratory results and concurrent medications...

Coordinate and assist in managing and participating in pharmacy services, including compounding and dispensing of medications, quality assurance and clinical monitoring activities. Participate in decisions regarding the pharmaceutical services within assigned scope including: Assessing the patient's general pharmaceutical needs Planning for the pharmaceutical services provision Participating in the overall plan of care Participating in the overall quality assessment and improvement plan Receive physician prescription orders and evaluate the appropriateness of these orders for dosage, drug choice, potential drug interactions, route of administration and stability Supervise the filling, receiving, compounding, and dispensing activities involved in providing finished product to the patient Ensure that the patient chart is complete for allergies, height, weight, current and past medical history, clinical laboratory results and concurrent medications (including...