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Clinical Pharmacist - Managed Care

at Health Care Service Corporation in Downers Grove, Illinois, United States

Job Description

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is invested in your future!
Job Summary
This Clinical Pharmacist is responsible for conducting clinical reviews to optimize drug therapy for health plan members across medical and pharmacy benefit channels. The clinical pharmacist will utilize sound knowledge of member and/or client benefit design to inform drug therapy recommendations at an individual or population level. Administration and management of pharmacy programs in scope will include but not be limited to applying knowledge of utilization/formulary management programs, specialty pharmacy management, medication therapy management, data analysis, client relationships/support; and development of innovative clinical programs. The pharmacist will work directly with a multi-disciplinary team to advise plan members and providers in an effort to improve health outcomes.

JOB REQUIREMENTS:
* Registered Pharmacist in Illinois.
* Experience using window based word processing, spreadsheet and relational database software.
* Drug information skills.
* Strong Verbal and written communication skills.
* Knowledge of practice guidelines or practice parameters; pharmacoeconomics; quality improvement processes and techniques.
* Knowledge of medication use evaluation principles.
* Ability to remain at a work station and perform computer entry for long periods of time, as required.
* Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management

PREFERRED JOB REQUIREMENTS:
* Effectively complete high dollar case reviews, data analysis and efficient care management / care coordination.
* 3 years of experience within Pharmacy practice.
* Additional certifications and residency experience.
* Managed care and/or Pharmacy Benefit Management (PBM) experience.
* Experience with Medication Therapy Management (MTM) reviews, Medication Action Plans (MAP) development.
* Knowledge in Specialty Pharmacy, Government Programs, Utilization Management, Controlled Substance Initiatives.
* Assist in developing Medication Utilization Evaluations (MUE).

We offer a flexible work arrangement to include 2 days work from home and requires 3 days working in the office.

Relocation is not available at this time.
Sponsorship is not provided.

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HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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Job Posting: 11837269

Posted On: Apr 17, 2024

Updated On: Apr 25, 2024

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