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DEPARTMENT: Clinical and Pharmacy Services
JOB TITLE: Managed Care Clinical Pharmacist 1, MTM Services Leader
REPORTS TO: Senior Managed Care Pharmacist
DIRECT REPORTS: None
FLSA STATUS: Exempt

JOB SUMMARY:

The Managed Care Clinical Pharmacist 1 serves as the MTM Services Leader and is also responsible for implementing the clinical services required by Ramsell's managed care sponsors/clients.

Working under the supervision of the Senior Managed Care Pharmacist, this pharmacist will take the lead in coordinating the efforts of the clinical team to both deliver the company’s Medication Therapy Management (MTM) services, and contribute to the development of the next iteration of the company’s MTM tool working collaboratively with other pharmacists in the department. The Managed Care Clinical Pharmacist 1 will serve as a clinical contact for both internal and external clinical issues. This position requires a pharmacist with an excellent clinical database, the ability to deliver MTM services telephonically, knowledge of managed care / PBM operations, P&T committee functions, and drug utilization management strategies.

RESPONSIBILITIES:

• Serves as the MTM Services Leader
• Responsible for performing comprehensive and targeted medication reviews to identify, resolve, and prevent medication-related problems for targeted members
• Responsible for ensuring that all of Ramsell MTM services meet quality assurance (QA) measures and contractual agreements
• Assists the Senior Managed Care Pharmacist in preparing MTM quality assurance reports, program service audits and data review, to meet sponsor needs
• Serves as a drug information and clinical resource to pharmacy technician PBM helpdesk staff
• Implements utilization management tools such as prior authorization programs and prospective or retrospective drug utilization review programs
• Supports formulary development, maintenance, management, and P&T Committee functions
• Provides current clinical study reviews, new drug and generic drug updates
• Assists in the ongoing development of protocols and procedures for PBM service administration
• Assists the Senior Managed Care Pharmacist in preparing the quality assurance reports, program service audits, data review, and program surveys as required to meet contract deliverables
• Assists in the management and development of fraud prevention and audit services
• Serves as a Clinical Liaison between Ramsell and program sponsors as assigned
• Provides clinical support to Account Managers for clinical requests and formulary administration
• Be aware of current and emerging clinical trends and educate clinical team, physicians and other prescribers
• Actively participation in clinical departmental meetings to improve clinical programs, enhance processes, and share clinical information
• Perform other duties as assigned to meet departmental objectives
• Follow all policies and procedures related to job

OTHER RESPONSIBILITIES:

• Makes presentations and lectures to professional organizations, government entities, and educational programs
• Other duties as assigned by the Senior Managed Care Pharmacist

REQUIREMENTS:

• Strong clinical pharmacy knowledge with HIV treatment expertise
• Excellent written and oral communication skills, good interpersonal skills
• Professional poise with demonstrated presentational skills
• High level of self-motivation, self-directed learner with attention to detail who is comfortable working in a team-oriented environment
• Problem solving and analytical skills
• Working knowledge of MS Office software, to include Word, Excel, PowerPoint, and Project
• Experience in collaborating with physicians and other prescribers on medication management and improving outcomes
• Strong customer service skills
• Commitment to professionalism and a dedicated desire to advance patient care

EDUCATION:

• Registered Pharmacist, licensed by the State Board of Pharmacy of CA
• Doctor of Pharmacy Degree

EXPERIENCE:

• Experience in clinical pharmacy practice in the ambulatory care or managed care setting; An emphasis in managed care is preferred
• Minimum 2 years’ of related pharmacy work experience
• Completion of ASHP accredited residency or equivalent experience in managed care environment is preferred
• Experience working with public health and government administered prescription drug programs is desirable

Please email your resume to: cdominguez@ramsellcorp.com