Pharmacist Health Plan - Drug Information

Job Summary

Depending on assigned area of expertise, the pharmacist will perform a variety of duties, including performing extensive literature review for the development of criteria for management of the pharmacy benefit, administering the pharmacy benefit in conjunction with the Health Plan Pharmacy Customer Service team members, delivering continuous, high quality member care while maximizing member satisfaction and managing appropriate utilization, among others duties assigned.

Job Duties

• Act as a liaison between the Health Plan and its customers with respect to pharmaceutical benefits.
• Serves as formulary expert for all lines of business and associated benefit designs.
• Serves as a resource for internal operations, providing information to customers regarding pharmacy and medical drug benefits, formulary details, and prior authorization details as needed.
• Supports prior authorization representatives in their duties related to medical necessity, formulary exceptions, and prior authorization reviews.
• Performs medical necessity reviews for formulary exceptions and prior authorizations according to specified timelines.
• Performs extensive literature review and develops clinical criteria for new and existing pharmaceuticals as part of a drug review function to be presented at the Pharmacy and Therapeutics Committee.
• Works closely with clinical enterprise to coordinate the best, most cost-effective, drug selection policies, and protocols for targeted disease processes.
• Suggests improvements and changes to perpetually improve operations.

Position Details

• Education: Bachelor's Degree-Pharmacy (Required)
• Experience: Not specified
• Certification(s) and License(s): Licensed Pharmacist (Pennsylvania) within 90 days - State of Pennsylvania

Purpose & Values

• Purpose: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.
• Values: KINDNESS, EXCELLENCE, LEARNING, INNOVATION, SAFETY

Benefits

• Healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.