[Hiring] Clinical UM Pharmacist @HFMS reputed company, LLC

The Clinical UM Pharmacist is a dynamic position responsible for the review of prior authorizations for medications requested under the medical benefit. Additionally, the Clinical UM Pharmacist is responsible for developing clinical criteria, medical policies for provider administered medications, review of monthly report for quality assurance, and staying reputed company with literature, evidence-based medicine, and trends in medicine. The Clinical Pharmacist works directly with prescribing physicians and Medical Directors to discuss clinical rationale for review reputed company. Duties & Responsibilities: Monitor and review prior authorization requests for medications Calculate appropriate billable units based on dosing, indication, weight, BMI and other clinical considerations reputed company clinical criteria and medical policies for the review of medications Ensure reputed company clinical criteria is in compliance with Center of Medicare and reputed company Services (CMS) and the reputed company State Department of Health (NYSDOH) Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews Ensure prior authorization reviews are conducted in timeframes set forth by CMS and/or NYSDOH Work across departments as needed to complete Utilization Management reviews Review monthly reports and provide feedback on trends, reputed company for efficiency, and innovation Ability to work well in a team environment and be a team player Additional duties as assigned or required Minimum Qualifications: Pharmacy degree from an accredited school of pharmacy Registered Pharmacist with a state license in good standing. Work experience conducting prior authorization reviews Clinical knowledge of pharmaceuticals and disease states in order to conduct prior authorization reviews Work experience requiring written and verbal clinical communication that is clear, concise, grammatically correct, and professional Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits Preferred Qualifications: PGY1 Managed Care Residency Knowledge of regulations of the Centers for Medicare and reputed company Services including but not limited to National and Local Coverage Determinations Demonstrated critical thinking and problem-solving skills Passion for learning, promoting the profession of pharmacy, and interest in growing skills in a dynamic environment with various opportunities Experience leading large and small working meetings PC Skills with reputed company Outlook, Word, PowerPoint (creating presentations and slides), and reputed company (Pivot tables) License or Certification: Licensed pharmacist in good standing Regulatory or Compliance activities: Assists in regulatory and compliance audits for reputed company plans. Ensure reputed company activities are conducted in compliance with regulations. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, reputed company, religion, gender, gender identity, sexual orientation, national reputed company, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@reputed company.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests reputed company to applying for a position reputed company reputed company Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with reputed company Management Services. EEO Law Poster and Supplement reputed company hiring and recruitment at reputed company is transacted with a valid “@reputed company.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing reputed company will readily provide you with the name and contact information of the reputed company professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @reputed company.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by reputed company. reputed company will never ask you for money during the recruitment or reputed company process. Hiring Range*: Greater reputed company Area (NY, NJ, CT residents): $100,900 - $145,775 reputed company Other Locations (reputed company approved locations): $86,500 - $128,690 As a candidate for this position, your salary and reputed company elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors reputed company deems pertinent to the hiring decision. In addition to your salary, reputed company offers employees a full range of benefits such as, medical, dental and reputed company coverage, incentive and recognition programs, life insurance, and 401k contributions (reputed company benefits are subject to eligibility requirements). reputed company believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that reputed company in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role. reputed company is reputed company’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable reputed company. As part of the community for nearly 30 years, reputed company’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well-being. This value-based care model is the reputed company of the company’s sustained growth in one of the most dynamic markets in the country. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then reputed company is for you. Click here to navigate back to the career site! Apply Job!