At Quantum Recruiters we focus intently on providing talent to leading employers throughout the Pacific Northwest. For over 80 years, our client has built a reputation based on taking great care of people by delivering insurance plans to individuals and business throughout the Northwest. We are currently recruiting to fill a full time, Clinical Pharmacist role.

This is a remote, contract role through October!

JOB PROFILE

The Clinical Pharmacist is responsible for participation in all day-to-day aspects of the Pharmacy Services Department, including but not limited to issuance of all pharmacy coverage decisions, development of policies and procedures and coordination of pharmacy benefits for members. Responsible for participation in the Pharmacy & Therapeutics (P&T) Committee including reviewing and presenting new drug reviews, drug class reviews, and policy reviews. Responsible for maintaining compliance with all state and federal legislation. Serve as a clinical resource person for Health Services staff, other internal associates, and external vendors as necessary.

JOB DESCRIPTION

Essential Responsibilities:

• Provide drug coverage determinations for members.
• Provide effective communication for members, providers, and internal staff through various platforms such as clinical calls, coverage determination letters, and email.
• Support clinical meetings with internal and external stake holders as requested.
• Review prescription formularies and criteria for needed updates based on clinical guidelines.
• Participate in P&T Committee meetings through review of new drugs, drug classes, and authorization policies with presentation of materials to staff members prior to meetings and to committee members during meetings.
• Lead and / or assist in projects as assigned.
• Stay up to date on State and Federal regulations as they relate to health insurance coverage.
• Stay up to date on quality measures pertinent to Pharmacy Services.
• Keep current with new and emerging clinical trends.

Supporting Responsibilities:

• Act as backup for other team members and departmental functions.
• Work with Clinical Pharmacy Manager and/or designed to improve processes, systems, reporting, and services provided by the department
• Represent Pharmacy Services Department, both internally and externally, as requested.
• Meet department and company performance and attendance expectations.

SUCCESS PROFILE

Work Experience:

Three or more years of pharmacy related work-experience is preferred. Additional experience managing complex work processes and working as part of a multidisciplinary care team is highly preferred. Prior success in healthcare integration, process development and program implementation is desirable.

Education, Certificates, Licenses:

Required to be a registered pharmacist with either Pharm D degree or Bachelor of Science in Pharmacy.

Additional certifications may be needed such state specific credentials. Certification support may be available for credentials needed post-hire. Post-graduate training (examples include Residency, Fellowship, MBA, BCPS) is preferred.

Knowledge:

Ability to adapt and prioritize within a fast-paced environment. High attention to detail. Knowledge and comprehension of pharmaceutical services, including federal and state statutes and regulations as they pertain to the insurance-related pharmacy services and benefits administration. Ability to assess pharmaceutical alternatives, treatment plans, drug technologies and new approaches to delivering pharmacy services. Strong verbal and written communication skills. Proficiency in Microsoft Office Suite. Ability to work independently and within groups with minimal supervision.

If you are a dedicated Clinical Pharmacist looking to make a difference in a dynamic environment, we encourage you to apply.