GENERAL SUMMARY
Employees assigned to this job are part of the Managed Care Pharmacy Residency Program, a one-year educational program accredited by the American Society of Health System Pharmacists (ASHP). The program allows post-graduate pharmacists to gain experience in managed care pharmacy, including the areas of formulary management, prior authorization, strategic benefit design, and pharmacy operations.
ESSENTIAL RESPONSIBILITIES
- Responsible for formulary management including, but not limited to, new drug reviews, drug monograph write-ups, managed care concept presentation, and therapeutic class reviews.
- Reviews prior authorization criteria and requests. Documents prior authorization criteria and policy.
- Researches drug information requests from internal and external customers. Provides effective medication education to Pharmacy, Health Services, Provider Relations, and Sales/Marketing departments.
- Reviews physician and member Drug Use Review (DUR) data to ensure effective utilization management.
- Assists the Pharmacy Manager with designing an effective pharmacy benefit structure to service a specific population’s needs. Attends product development meetings.
- Develops draft formulary communications for member and physician mailing. Develops and/or presents communications for internal customers’ use.
- Participates in Pharmacy and Therapeutics (P&T) Committee, Pharmacy Subcommittee, and pharmacy-related HEDIS workgroup meetings. Attends Quality Management Committee (QMC), Quality Improvement Committee (QIC), Commercial and Medicare complaint, and pharmaceutical industry meetings.
- Participates in community-wide health initiatives.
- Reviews member educational materials. Provides Pharmacy input to Disease State Management (DSM) team.
- Conducts a managed care outcomes research project using effective project management skills.
- Presents project at Academy of Managed Care Pharmacy (AMCP) Annual Meeting. Develops a manuscript of the outcomes research project for publication submission to Journal of Managed Care (JMCP).
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Current unrestricted state license as a Registered Pharmacist or eligibility for licensure required.
- Resident must obtain a license no later than October 1 of the residency year.
- PharmD degree from an ACPE (Accreditation Council for Pharmacy Education) accredited College of Pharmacy.
- Strong clinical pharmacy knowledge.
- Excellent verbal and written communication skills.
- Ability to work independently and in a team environment.
- Excellent organization and project management skills.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Kansas City, MO, US
Organization: 10300 - Coventry Services Corp
Schedule: Full-time
Job Posting: 2012-08-31 00:00:00.0
Job ID: 1211256