Clinical Pharmacist, South San Francisco, CA
The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a Clinical Pharmacist to provide pharmacotherapy expertise in support of the Clinical Pharmacy Programs, Pharmacy and Therapeutics (P&T) Committee, drug formulary, prior authorization and drug utilization review. The essential duties and responsibilities will include the following:
- Perform clinical review of Prior Authorizations and Appeal requests for all lines of membership.
- Prepare for bimonthly or monthly Pharmacy and Therapeutics (P&T) meetings (new drug reviews for CA and Medi-Cal formularies, drug class reviews for CA).
- Provide clinical expertise and perform case review in the Clinical Pharmacy Program which includes the Clinical Pharmacy Outreach Program (CPOP – a counter-detailing program), MTM-LTC, Pharmacy Case Review, CMS Star Rating Clinical Initiatives.
- Provide support for the development and maintenance processes of all HPSM formularies for all lines of membership.
- Provide technical help desk support to resolve internal and external inquiries related to pharmacy claims adjudication, benefits, formulary and prior authorization.
- Prepare and provide support in all (onsite and desk) audit activities related to Pharmacy Unit
- Perform intern teaching/preceptor duties through partnership with various institutions.
- Perform other duties as assigned
License and Certification: A valid California license as a Pharmacist.
Education and Experience: PharmD from an ACPE accredited college of pharmacy program is required. Equivalent to two (2) years work in a clinical pharmacy. Managed care experience is required.
Knowledge of: Therapeutic drug utilization. Medicare Part D, Medi-Cal and Managed Care programs. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.
Ability to: Communicate effectively, verbally and in writing. Proficiently use computers and related software applications. Provide effective customer service. Demonstrate sound math, analytical, and problem solving skills.
Other: Valid Driver’s License, own vehicle, and auto insurance.
Starting Compensation Range: Between $90,073 - $130,431 depending on experience.
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s coverage in the medical HMO plan and majority of PPO medical cost. Employee pays a small portion of the dependent premiums for medical and dental benefits. Additional HPSM benefits include fully paid vision, life, AD&D, STD, and LTD insurance; retirement plan (10% of salary for compensation/HPSM paid); holiday and vacation pay; tuition reimbursement plan; and more.
Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: email@example.com or via fax: (650) 616-8039. File by: Continuous until filled. EOE