Experience Inc. Jobs

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13199885

What youll do

• Provide pharmacy practice, drug product, and drug therapy expertise to the company for utilization review, medical review, customer service and claims processing activities.

• Participate in formulary, benefit design, network, and medical policy recommendations

• Develop and enhance a professional working relationship with providers, pharmacies, professional organizations and other parties involved in the management of the Plans Pharmacy Benefits

• Participate and engage in internal and external meetings or committees as a representative of the pharmacy team and Medical Affairs Division

• Assess Plan Pharmacy Benefit practices to determine compliance with federal regulations and laws

• Collaborate with internal and external stakeholders to enhance member access to appropriate and affordable therapies, including communication of changes to groups, providers, and members.

• Assist and support quality management programs that promote measurement, monitoring, and evaluation of services and work processes to improve the quality-based activities and outcomes

• Provide vendor oversight and monitoring of clinical programs put into place alongside the Pharmacy Benefit Manager

• Serve as a resource for resolving pharmacy claims, customer service escalations, and provider inquiries related to coverage and utilization.

What you need

Knowledge/Skills/Abilities

• \

  Requires strong knowledge of clinical pharmacy, chronic disease management, biologic and biopharmaceutical products, drug information systems, and drug delivery system.

• Requires knowledge of pharmacy practice, including trends and reimbursement, at the national and local level.

• Requires strong knowledge of State and Federal pharmacy laws and regulations

• Requires working knowledge in the evaluation of clinical drug trials, outcomes research and Pharmacoeconomics.

• Requires an understanding of formulary and utilization management

• Demonstrates interpersonal skills, and is able to easily collaborate within the department, organization, and with vendors

• Strong organizational skills with the ability to managed multiple tasks and priorities

• Advanced verbal and written communication skills and the ability to present to small and large groups

Education and Experience

• Bachelor of Science in Pharmacy or Pharmacy Doctorate (PharmD)

• Must have or be able to obtain a current unrestricted license to practice pharmacy by the Kansas State Board of Pharmacy within 90 days of hire

• Minimum of three years experience in retail pharmacy, clinical practice, or one-year post-graduate training in a Post Graduate Year 1 (PGY1) residency with emphasis in Managed Care

• Masters of Business Administration (MBA), Masters of Health Policy (MHP), Board Certification in Pharmacotherapy (BCPS), or equivalent degree or certification preferred, but not required\

Physical Requirements

• Position requires use of a PC\

Benefits & Perks

• Base pay is only one component of your competitive Total Rewards package

• Incentive pay program (EPIP)

• Health/Vision/Dental insurance

• 6 weeks paid parental leave for new mothers and fathers

• Fertility/Adoption assistance

• 2 weeks paid caregiver leave

• 5% 401(k) plan matching

• Tuition reimbursement

• Health & fitness benefits, discounts and resources