Denver Health Pharmacist Clinical Specialist in Denver, Colorado

Job Summary Under general supervision reviews prior authorization requests (PARs), performs retrospective drug utilization reviews and assists with complex pharmacy case management for Commercial, Medicaid, Medicare, Child Health Plan Plus, and Healthcare Exchange plans. This individual is responsible for the oversight of Medicaid pharmacy utilization as well as creating programs to improve Medicaid pharmacy related outcomes measures. The incumbent identifies, develops and maintains clinical criteria for prior authorizations, step therapy and Medicaid initiatives. In addition, they will participate in other projects as assigned and act as a liaison to the DHMP contracted providers and pharmacies. Minimum Qualifications Education: BS Pharm and/or PharmD

Experience: Typically two years of direct clinical experience or as a prior authorization pharmacist or completion of a pharmacy residency program with direct patient contact including: conducting medication therapy management reviews, providing drug information, providing dosing and drug modifications as well as recommending formulary alternatives. The candidate must work well in a team environment and possess strong verbal and written communication skills. Certification in Managed Care, Medicaid/Medicare guidelines is a plus. The individual must be capable of providing educational training to nurses, staff and/or patients when requested. Bilingual English/Spanish preferred

Knowledge, Skills & Abilities: Critical thinking, clinical evaluation, verbal communication, written communication and teamwork skills Ability to multi-task; develop guidelines; prioritize and meet regulatory requirements

Certificate/License/Registration: Actively licensed pharmacist by the Colorado State Board of Pharmacy at the time of application. All Certifications and Licenses required for this job must be kept current as a condition of continued employment. Facility: Managed Care, 938 Bannock St.

Area of Interest: Managed Care

Shift Type: Day

Requisition ID: 47766


Employment Type: Full-Time

Minimum: $114,363.703

Experience Required: 1 - 3 Years

Mid-point: $128,677.641

Education Required: Bachelors Degree

Maximum: $142,970.453

Certification/Licensure/Registrations Required: State of CO Pharmacy License