[Hiring] Clinical Pharmacist, Utilization Management (Part B Drugs) @Devoted Health Services, Inc

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This position represents an amazing opportunity for an ambitious early-mid career pharmacist to join a high performing pharmacy team. You’ll be a core member of the Pharmacy Team’s Utilization Management department to work on controlling the costs of complex treatments. You will strive to ensure that our members get the right treatment at the right time all while supporting the mission of our company to treat each member like family along the way. We are committed to helping and supporting you to learn and gain the experience that you need to achieve your career development goals. This is an exciting opportunity to help us build and grow our health plan pharmacy program and deliver the best possible care to our members! • Utilization Management • Reviewing prior authorization requests for drugs and biologics, as well as products covered under our part B benefit. • Reviewing appeals of previously denied requests. • Ensuring members (and their providers) understand their benefits and how they can be used to better their health. • Providing support for internal clinical and non-clinical staff in understanding our policies and procedures. Qualifications • A pharmacist (RPh) with 2 or more years of utilization management experience and/or completion of a managed care residency. • Applicable specialty pharmacy experience also considered. • Doctorate of Pharmacy degree (PharmD). • Actively licensed in at least one state. • Must be willing to work Monday-Friday 12PM to 8:30PM EST (Eastern Standard Time). • Rotating weekend on call and holidays is required. • Experience with pharmacy-related quality assurance (QA) work is strongly preferred but not required. Requirements • An appreciation of Medicare regulations and policies and how Medicare pays for drugs. • A keen understanding of how the interactions between payers, providers, and drug manufacturers ultimately affect the patient. • Experience working as part of a multidisciplinary care team, especially during transitions of care. Benefits • Employer sponsored health, dental and vision plan with low or no premium. • Generous paid time off. • $100 monthly mobile or internet stipend. • Stock options for all employees. • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles. • Parental leave program. • 401K program. • And more.... Apply tot his job
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