Job Description
Are you a passionate and experienced Pharmacist looking to make a real impact on healthcare access for Nevadans? We're seeking a talented Pharmacist II to join our team and provide clinical expertise within the Nevada Medicaid pharmacy benefit. This is a full-time contract position offering a unique opportunity to contribute to a vital program. If you're a detail-oriented professional with a strong clinical background and a desire to serve your community, we encourage you to apply!
About the Role:
As a Pharmacist II, you'll play a crucial role in ensuring that low-income Nevadans have access to quality healthcare services. Working within the Nevada Medicaid program, you'll provide clinical reviews, assist with prior authorization requests, develop policies, conduct audits, and advise on benefit design. You'll be a key resource for internal departments, Pharmacy & Therapeutics Committees, and other stakeholders. This position offers a hybrid work schedule, allowing for a balance between in-office collaboration (Carson City or Reno) and remote work.
What You'll Do:
Perform clinical reviews of medical and outpatient pharmacy utilization management criteria and cases, applying your clinical judgment and adhering to program policies and regulations.
Assist with drug prior authorization exception requests and appeals reviews, ensuring patients receive the medications they need.
Develop clinical guidelines and policies based on the latest research and best practices.
Conduct audits of the pharmacy benefit across Fee-for-Service and Managed Care Organizations (MCOs) to identify areas for improvement.
Testify at appeals hearings, providing expert testimony on clinical matters.
Evaluate offsetting costs and advise on rebate program changes, contributing to the financial sustainability of the program.
Assist in the administration of the pharmacy benefit, ensuring smooth and efficient operations.
Analyze utilization trends and recommend changes to benefit design to optimize patient outcomes and drug spend.
Manage the formulary, including developing clinical pharmacy utilization management criteria, making cost decisions, and determining benefits.
Participate in the development and execution of clinical quality assurance programs.
Provide clinical guidance and support to internal departments.
Assist with developing cost-effective pharmacy measures and provide oversight of Pharmacy Benefits Managers (PBMs).
Develop and present drug monographs, executive summaries, therapeutic class reviews, and medication policies to Pharmacy & Therapeutics Committees (DUR and SSSB boards).
Provide oversight of the administration of the Preferred Drug List (PDL) and evaluate its impact on prescription drug spending.
Perform other related duties as assigned.
What You'll Bring:
A Doctor of Pharmacy (PharmD) degree or equivalent education that meets pharmacist license requirements.
A current, valid Pharmacist license in good standing in any state.
Two or more years of experience in clinical, managed care, health plan, or pharmacy benefit management.
Proficiency in evaluating drug literature, clinical trial data, and electronic database information.
A strong clinical and analytical background, particularly with specialty medications, is preferred.
What We Offer:
Highly competitive salary (up to $74/hour).
Regular work hours with flexible schedule options.
Hybrid work schedule (in-office and remote).
W2 employee status.
Comprehensive benefits package available for full-time employees, including health, dental, and vision insurance.
Paid time off (PTO) with annual increases.
Continuing education unit (CEU) and professional development reimbursements.
No-cost professional liability insurance.
Employment Type: Full-Time
Salary: $ 64.00 Per Hour
Job Tags
Hourly pay, Full time, Contract work, Flexible hours,