Description:
GENERAL SUMMARY
Performs prospective and/or retrospective drug utilization review. Coordinates the distribution of clinical drug information and educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens.
ESSENTIAL RESPONSIBILITIES
Identify opportunities within the health plans for integration of quality measures in current case management or other clinical programs.Communicate to providers and members on quality indicators for Medicare programs.Provides clinical pharmacy support to programs targeted towards the Medicare membership.Coordinates and provides drug reconciliation in Medicare members enrolled in clinical programs.Maintains communication with nurses, medical directors, and other health professionals involved in Medicare case and disease management programs.Improves quality of service to members by developing programs to provide optimal pharmacy care to patients, participating in dispute resolution of drug utilization review, measuring and documenting improvements in patient care.Collaborates with other medical personnel in developing treatment guidelines and demonstrates the impact of these guidelines. May participate in formulary development and management.Monitors prescribing habits of participating physicians. Makes recommendations to physicians to improve medication regimens as appropriate.Assist in development and implementation of Medicare Part D Stars Rating quality initiatives.May develop and maintain a newsletter for provider staff, promoting rational prescribing habits.Resolves pharmacy claims issues for network pharmacies not paid on-line.Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Current unrestricted state license required.
- Bachelor's degree from an accredited school of pharmacy or PharmD from an accredited school of pharmacy required.
- Board certification and residency preferred.
- Previous (1-3 years) clinical pharmacy experience required. Managed care experience preferred.
- Strong pharmaceutical product and clinical pharmacy knowledge required.
- Knowledge of clinical program components, formulary designs, and prescription benefit trends.Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: , , US
Other Locations: ,
Organization: 37200 - Coventry Product Services, Inc
Schedule: Full-time
Job Posting: 2013-08-13 00:00:00.0
Job ID: 1312513
GENERAL SUMMARY
Performs prospective and/or retrospective drug utilization review. Coordinates the distribution of clinical drug information and educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens.
ESSENTIAL RESPONSIBILITIES
Identify opportunities within the health plans for integration of quality measures in current case management or other clinical programs.Communicate to providers and members on quality indicators for Medicare programs.Provides clinical pharmacy support to programs targeted towards the Medicare membership.Coordinates and provides drug reconciliation in Medicare members enrolled in clinical programs.Maintains communication with nurses, medical directors, and other health professionals involved in Medicare case and disease management programs.Improves quality of service to members by developing programs to provide optimal pharmacy care to patients, participating in dispute resolution of drug utilization review, measuring and documenting improvements in patient care.Collaborates with other medical personnel in developing treatment guidelines and demonstrates the impact of these guidelines. May participate in formulary development and management.Monitors prescribing habits of participating physicians. Makes recommendations to physicians to improve medication regimens as appropriate.Assist in development and implementation of Medicare Part D Stars Rating quality initiatives.May develop and maintain a newsletter for provider staff, promoting rational prescribing habits.Resolves pharmacy claims issues for network pharmacies not paid on-line.Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Current unrestricted state license required.
- Bachelor's degree from an accredited school of pharmacy or PharmD from an accredited school of pharmacy required.
- Board certification and residency preferred.
- Previous (1-3 years) clinical pharmacy experience required. Managed care experience preferred.
- Strong pharmaceutical product and clinical pharmacy knowledge required.
- Knowledge of clinical program components, formulary designs, and prescription benefit trends.Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: , , US
Other Locations: ,
Organization: 37200 - Coventry Product Services, Inc
Schedule: Full-time
Job Posting: 2013-08-13 00:00:00.0
Job ID: 1312513
