Recruiter.com - Louisville, KENTUCKY
|Provides clinical pharmacy direction for the state health plans including, but not limited to Medical Economics, Disease Management, Pharmacy, Utilization and Quality Management.
Provides drug utilization review. Assists in development of goals and objectives for the clinical pharmacy programs.
Serves as resource for drug information.
Implements the requirements of the Plan?s contract with the state governing agency as it pertains to prescribed drug services and other pharmacy related items for the Medicaid line of business.
Assists with the development, presentation, and implementation of policies and procedures consistent with the regulatory requirements of the contract.
Oversees pharmacy utilization and produces informative reports to the respective markets in each region.
Works directly with the respective Medical Director of each region along with the Medical Economics department to ensure cost effective management of both medical and pharmacy utilization as part of the Network Improvement Program (NIP).
Assists in educating clinical pharmacist managers for the region providing information on clinical and trend issues.
Implements and maintains the pharmacy benefit program for the State.
Implements and maintains the NIP program specific to pharmacy utilization.
Reviews prescribing practices on high utilizing physicians and intervening as needed providing drug information on pharmacy expenses Recommends changes in prescribing practices to improve quality and lower costs.
Provides detailed claim analysis for over and under utilization Reviews pharmacy data to look for savings opportunities Provides clinical pharmacy support for Pharmacy, Disease Management programs, Quality and Utilization Management with and emphasis on Diabetes and asthma.
Provides in service education to staff.
Provides drug utilization reviews as needed.
Provides clinical reviews of DER request as time permits.
Performs special duties as needed Education: A Bachelor ' s in Pharmacy.
A Pharm D preferred Experience: 7+ years experience as a certified pharmacist with experience in managed care.
3+ years of management experience. Experience in pharmacy operations.
Licenses/Certifications: Licensed pharmacist in state of operation.
Licensed consultant in state of operation.
Special Skills (e.g. 2nd language): Strong oral and written communication skills.
Ability to use pharmaceutical and medical reference, literature to provide drug information to the health plan.
Ability to evaluate information from both oral and written sources and develops clear, concise and crisp reports.
Excellent interpersonal skills with the ability to influence others.
Ability to evaluate financially the impact of drug products.Recruiter.com . Category: Pharmaceutical, Keywords: Pharmacy Director