Description

The Clinical Pharmacy Specialist manages accessibility, quality, and cost-effectiveness of drug and medical therapy for members and providers. This position focuses on initiating, supporting, and continuing cost-effective, rational drug, and disease therapy, utilizing distinct but inter-related management and cross-departmental functions.

Job Responsibilities

• Responsible for providing clinical support services to client plan(s) contracting for clinical services

• Support services will include, but not limited to, clinical review, analysis, recommendation, decision and documentation of prior authorization requests, medical exception requests, and appeal requests as required by client contracts and Utilization Management delegation agreements

• Review medication request guidelines for clinical appropriateness and operational efficiency

• Assist in the revision and creation of new or existing medication request guidelines as indicated

• Provide drug information support

• Research and provide clinical literature documentation to support prior authorization decisions as indicated

• May include preparation of Pharmacy and Therapeutics meeting agenda and associated meeting materials including clinical and financial reviews of individual drugs, drug classes, and current therapy for specific disease states and drug formulary review

• Coordinate and assist in the preparation of utilization and compliance reporting for client plans

• Ensure timely preparation and review of plan data and client presentations, when required

• Coordinate and assist with projects associated with prior authorization program development, implementation and internal and external communications

• Provide feedback to Prior Authorization Coordinators (PACs) regarding the processing of PA cases referred for clinical review

• Provide in-service education to PACs regarding topics such as PA guidelines, diagnoses commonly seen as part of the PA review process

Qualifications

• Pharmacy degree (Pharm. D.) or equivalent

• Two (2) to five (5) plus years related experience and/or training; or equivalent combination of education and experience

Computer Skills: To perform this job successfully, an individual should have knowledge of Microsoft Office Suite Word Processing software.

Experience Level

Intermediate Level

Pay and Benefits

The pay range for this position is $61.75 - $61.75/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision• Critical Illness, Accident, and Hospital• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available• Life Insurance (Voluntary Life & AD&D for the employee and dependents)• Short and long-term disability• Health Spending Account (HSA)• Transportation benefits• Employee Assistance Program• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Apr 4, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent

• Maintaining an inclusive environment through persistent self-reflection

• Building a culture of care, engagement, and recognition with clear outcomes

• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.