Medicaid Clinical Pharmacist
The Clinical Pharmacist (Medicaid focused) manages clinical and operational pharmacy processes for the Health Choice beneficiaries by assisting in the maintenance of plan formulary, participating in the Pharmacy and Therapeutics (P&T), creating and managing drug use criteria and protocols, reviewing requests for prescription drug services and complex member cases, participating in efforts to improve performance measures, and working closely with the designated PBM to ensure pharmacy benefit is compliant with governmental regulations and requirements. The Medicaid Clinical Pharmacist also educates appropriate Health Choice staff on specific clinical and operational Medicaid benefit pharmacy topics, processes and documentation and assists the Pharmacy Director as needed.
Candidates considered for this position will have a background in PBM or health plan pharmacy preferred. Other candidates may have experience in prior auth pharmacy, acute care pharmacy, and retail.
The pharmacist will manage pharmacy benefits consistent with AHCCCS requirements, implement, maintain, and enforce policies and procedures for pharmacy benefit in accordance with accreditation, state and federal guidelines and requirements, and serve as a clinical reviewer for requests for prescription drug services and complex member cases.
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
Pharmacy degree from an accredited college of pharmacy
Arizona or Utah state pharmacy license
Pharmacy licensure in good standing
Current AZ or UT drivers license, reliable transportation, and current insurance coverage
At least five (5) years of practice experience with a health plan pharmacy service, managed care environment, and/or retail or hospital pharmacy service
At least two (2) years of practice experience in developing and applying drug use criteria