Clinical Specialist - Part Time

About the role

The Clinical Specialist manages accessibility, quality, and cost-effectiveness of drug and medical therapy for members and providers. This position focuses on initiating, supporting, and continuing cost-effective, rational drug, and disease therapy, utilizing distinct but inter-related management and cross-departmental functions. Essential Duties and Responsibilities include the following. Other duties may be assigned. Responsible for providing clinical review support services to client plan(s) contracting for clinical services. This includes reviewing prior authorization requests and either deciding to approve or deny the request. Support services also include, but not limited to, clinical review, analysis, recommendation, decision and documentation of prior authorization requests, medical exception requests, and requests as required by client contracts and Utilization Management delegation agreements; Review medication request guidelines for clinical appropriateness and operational efficiency. Assist in the revision and creation of new or existing medication request guidelines as indicated. May consult regarding a PA request directly with a client representative or an internal Subject Matter Expert or contact a dispensing pharmacist, prescriber or prescriber representative to obtain additional information; Provide drug information support. The position may also need to follow general guidance from the client on the handling of specific request types (non-formulary, quantity exceptions, etc.) Research and provide clinical literature documentation to support prior authorization decisions as indicated. Coordinate and assist in the preparation of utilization and compliance reporting for client plans. Ensure timely preparation and review of plan data and client presentations, when required; Coordinate and assist with projects associated with prior authorization program development, implementation and internal and external communications; Supervisory Responsibilities This job has no supervisory responsibilities. Client Responsibilities This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Requirements

• Education and/or Experience
• PharmD and 3+ years' experience or equivalent combination of education and experience, and 1 year of SME in respective areas
• Computer Skills
• To perform this job successfully, an individual should have strong computer skills with Microsoft Office and Microsoft Outlook; good working familiarity with databases and internet searches.
• Certificates, Licenses, Registrations
• Current, unrestricted license as a Registered Pharmacist in any state of the United States required.
• Other Skills and Abilities
• Excellent working knowledge of all types of pharmacy services with an emphasis on the managed health care environment.
• Expertise in clinical application of pharmacy practice.
• To perform this job successfully, an individ

Benefits

Additional Information

Exemption Status: United States of America (Non-Exempt) $52.17 - $73.30 - $94.43 "Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate." This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description

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