Managed Care Clinical Pharmacist - Community Health Choice
JOB SUMMARY:The Clinical Pharmacist provides highly specialized integrated clinical pharmacy services to the health plan. The Pharmacist will provide drug utilization reviews based on establish protocols for prior authorization and appeal requests, and to provide educational outreach to prescribers as appropriate. The Managed Care Clinical Pharmacist will assist with: Developing prior authorization review criteria for medications covered on pharmacy and medical benefits Conduct oversight over prior authorization criteria and delegated utilization management functions performed by PBM Reviewing PBM's formularies to identify improvement opportunities Create and refine policies and standard operating procedures for pharmacy oper
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To improve the patient experience by providing health care providers; patients and their families; and others with information, education, networking opportunities, and related resources focused on best practices.