Pharmacist - Pharmaceutical Systems and Policy, School of Pharmacy

About the role

The Department of Pharmaceutical Systems and Policy in the School of Pharmacy at West Virginia University is currently accepting applications for a Pharmacist at the Rational Drug Therapy Program. You will be responsible for conducting clinical reviews of prior authorization requests, performing concurrent drug utilization review with program instructions, and providing general pharmacy information using the point-of-sale computer system established by the West Virginia Bureau of Medical Services (WVBMS) and the current point-of-sale computer system utilized by the PEIA program.

Through this role, you will assist in carrying out Rational Drug Therapy Program’s mission to ensure WV Medicaid, WV PEIA, and CHIP members receive safe, rational, cost effective, and patient outcome-oriented drug therapy. In this role, you will additionally be performing reviews of prior authorization requests for the Peak Healthcare program in the computer system utilized by that program.

Benefits

• A 37.5-hour work week
• 13 paid holidays (staff holiday calendar)
• 24 annual leave (vacation) days per year (employee leave)
• 18 sick days per year (for when you’re ill, for when you need time to care for sick family, for your own, or your family’s, regularly scheduled medical appointments).
• WVU offers a range of health insurance and other benefits
• 401(a) retirement savings with 6% employee contribution match, eligibility to continue health insurance, and other retiree perks.
• Wellness programs

What You'll Do

• Provide professional services to the WVBMS which include but are not limited to:
• Prior authorization clinical review.
• Evaluations of appropriateness of therapeutic duplication.
• Recommendations of appropriate formulary alternative.
• Conduct reviews of home infusion therapy request.
• Literature reviews applicable to prior authorization request.
• Clinically evaluate the appropriateness of various infectious disease drug therapy regimens.
• Evaluate the clinical appropriateness of drug therapy approval with newly marketed medications as allowed by the program.
• Review individual prior authorization, drug utilization review, and billing inquiries and use clinical decision-making skills and therapeutic judgment to determine if claim payment can be approved.
• Acquire and maintain clinical knowledge and information on various disease states in which the program is involved via current, evidenced-based recommendations.
• Respond to inquiries in a friendly, professional manner.
• Aid in the orientation and training of all new professional and non-professional personnel.
• Weekend staffing of the program on a rotating basis (approximately every 7-10 weeks depending on staffing needs).

Qualifications

• Bachelor’s degree in Pharmacy or Doctor of Pharmacy Degree
• A minimum of one (1) year of experience in the following:
• Retail or hospital pharmacy experience

Knowledge, Skills And Abilities

• Demonstrated ability to make valid clinical judgments concerning a patient's drug therapy needs, given the guidelines of the program.
• Demonstrated excellent verbal and written communication skills.
• Demonstrated ability to work as a team player and make constructive suggestions to appropriate peers and supervisors.
• Exhibits excellent customer service skills and orientation.
• Exhibits excellent skills in handling difficult persons.
• Demonstrates knowledge of appropriate drug use in most common disease states.
• Exhibits a strong understanding of retail pharmacy operations and insurance billing processes associated with retail pharmacy operations.
• Demonstrated excellent computer data entry, software (Windows based), and typing skills.
• Able to follow guidelines and convey information in an accurate manner.
• Exhibits the flexibility and the ability to work with different insurance plans and different guidelines.
• Demonstrates the ability to perform duties in compliance with WVU HIPAA and patient confidentiality requirements.
• Able to maintain proper unit attendance and punctuality standards.

About WVU

West Virginia University is a place of purpose and community. We take pride in our profound impact on the state of West Virginia and are committed to the personal and professional growth of our employees. From the groundbreaking R1 research at our flagship campus in Morgantown to the career-oriented programs at WVU Potomac State in Keyser, and the technology-intensive programs at WVU Tech in Beckley, the contributions of WVU employees resonate across the state, touching lives and shaping futures. At WVU, you will discover a supportive community that champions work-life balance and fosters a collaborative atmosphere. Our core values — service, curiosity, respect, accountability and appreciation — unite us as Mountaineers. Join us at West Virginia University, where your work will make a lasting impact. To learn more about WVU, visit wvu.edu.

Equal Opportunity Employer

We invite all qualified applicants regardless of race, color, religion, sex, national origin, age, disability, genetic information, or Veteran status.