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Clinical Pharmacist (Prior Authorizations/Referrals) in Orange at Prospect Medical Systems

Date Posted: 4/4/2019

Job Snapshot

Job Description



Clinical Pharmacist

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The main responsibilities of the pharmacist is to review pharmacy authorization requests, develop strategies to manage high cost drugs, and provide support for clinical committees.



Job Responsibilities/Duties

  • Handle daily pharmacy referrals for injectables and infused medications. – 1) Review pharmacy referrals based on pharmacy authorization requests for injectables, infusion, diabetic supplies, insulin pumps based on health plan contracts, state & federal guidelines and medical necessity criteria; 2) Develop workflows and job aids for high cost drugs for internal staff; 3) Identify utilization management strategies for high cost drugs; 4) Review cap deducted claims and prepare comments for contestation.
  • Provide support for the Pharmacy & Therapeutics Committee, Utilization Management Committee, and Quality Management Committee. Develop utilization management protocols for drugs including injectables, infusion therapies, chemotherapeutic agents, and vaccines and internal treatment algorithms.  Present new drug reviews, therapeutic class reviews, drug usage guidelines, and clinical programs to the Pharmacy & Therapeutics Committee.


Qualifications

Minimum Education:  Graduate of an accredited School of Pharmacy recognized by the California State Board of Pharmacy. An advanced degree such as a Doctor of Pharmacy or Masters of Sciences is preferred.

Minimum Experience: A candidate with prior authorization is required.A prior pharmacy residency program or managed care experience (e.g., health plans, pharmacy benefit management companies, medical groups) is preferred.

Req. Certification/Licensure: The candidate must hold an active pharmacist license in the state of California.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance


How to Apply

To apply for this role, or search our other openings, please visit   http://pmh.com/careers/  and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm

Keywords: Pharmaceutical, Pharm, Chemists, Druggists, Pharmacy Related Functions, Dispense Prescription Medication, Safe and Effective Medication Use. Medicati on Advice, Medication Usage, Dosage, Prescriptive



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