Clinical Pharmacist

Summary

The staff pharmacist will, under general direction:  provide pharmaceutical expertise to staff and management within a healthcare account; provide supervision to pharmacy prior authorization/clinical call

center to ensure operations are meeting contractual service level agreements; monitor the maintenance of the drug data file to ensure accuracy and currency of files; act as a liaison to pharmaceutical

providers assisting in the adjudication of claims and prior authorizations; recommend and promote beneficial changes to customer programs; interpret and apply state regulations to claims processes and the

State of Oregon’s Preferred Drug List; represent Gainwell in professional associations. 

Your role in our mission

• Interact with customers 
   
• escalating calls from providers 
   
• entering prior authorizations 
   
• clinical medication review 

What we're looking for

• A current Pharmacist license and a pharmacy degree from an accredited college or university are required.
   
• At least three (3) years of experience in pharmacy healthcare benefits management, and Retrospective and prospective Drug Utilization Review experience.
   
• Medicaid experience.
   
• Previous or concurrent experience with prior authorizations administration.
   
• Experience with claims data analysis.
   
• 5 or more years of experience in a clinical pharmacy setting, with managed care pharmaceutical service experience a plus.
   
• Knowledge of current research and best practices relating to specialty medications.
   
• Analytical and research expertise to conduct drug class and clinical reviews involving prescribing behavior to reach pragmatic conclusions.
   
• Strong written, oral and clinical communication skills to collaborate with physicians, prescribers, pharmacists and Gainwell leadership.
   
• A caring people leader who understands their role on a team and can effectively delegate tasks.

What you should expect in this role

• Opportunities to travel through your work (0-10%)
   
• 8am - 5pm PST