[Remote] Clinical Pharmacist

Note: The job is a remote job and is open to candidates in USA. Horizon Blue Cross Blue Shield of New Jersey is a leader in health solutions, dedicated to improving healthcare quality and member experience for over 90 years. The Clinical Pharmacist role involves supporting pharmacy clinical management, including formulary management, medication therapy management, and utilization management, while collaborating with various healthcare professionals.ResponsibilitiesSupports the pharmacy formulary management program, medication therapy management program, and related P&T committee activitiesSupports prior authorization program by handling prior authorization requests from Pharmacies and physicians through existing policies and proceduresInterfaces with medical directors, and other areas for Pharmacy related initiativesSupports the Utilization management programResponsible for member interface through comprehensive medication review for Medicare beneficiariesAssist in managing and training Pharmacy techs for Medication therapy managementResponsible for Medicare beneficiaries pharmacy management program, understand the mandates and follow the guidelinesSupports clinical programs both internally and externallyAssists with the internal drug information servicesOn call responsibility as requiredReviews and analyze reports on utilization management, and evaluates business needs for data analysisSupport the Drug Utilization review programManage and update formulary communicationsCoordinates projects with activities performed by other clinical Pharmacists for the residents and studentsParticipates in the Pharmacy Case Management ProgramSupports the pharmacy lock-in program including profile review and presentationMaintains and reports relevant drug pipeline/patent loss detail to medical teamSupports the timely review of Pharmacy appealsAssists in the creation of member and provider newslettersSkillsRequires a bachelor's of science degree in pharmacy from an accredited college or universityActive Unrestricted NJ Pharmacy License RequiredRequires working knowledge of pharmaceutical and managed care industriesRequires knowledge of a spreadsheet software packageRequires knowledge of a database software packageRequires knowledge of Clinical therapeutics and basic therapy and guidelines and recommendationsRequires knowledge of Internet clinical information databasesStrong negotiation skills with the demonstrated sales ability to convert prospect to client in addition to demonstrated persuasive skills with carriersMust have effective verbal and written communication skills and demonstrate the ability to work well within a teamDemonstrated ability to deliver highly technical information to less technical individualsMust demonstrate professional and ethical business practices, adherence to company standards, and a commitment to personal and professional developmentProven time management skills are necessaryMust demonstrate the ability to manage multiple priorities [or tasks], deliver timely and accurate work products with a customer service focus, and respond with a sense of urgency as requiredDemonstrated ability to work in a production focused environmentProven ability to exercise sound judgment and strong problem solving skillsProven ability to ask probing questions and obtain thorough and relevant informationMust be client service focused with effective ability to empathizeNeeds to demonstrate willingness to cross-train, and be cross-trained, in other roles/dutiesMust be detail oriented with strong organizational and data processing skillsProven ability to follow detailed instructions is essential, along with proven problem solving skillsProven analytical, research and problem solving skills a mustMust demonstrate the ability to learn quickly and apply learning to new situationsMust exhibit flexibility to change as appropriateMust demonstrate the ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general publicExhibits an energetic, inquisitive, positive approach to problem solvingDemonstrated ability to make decisions with little need for direction and to function effectively as a team-oriented, self-starter working across cross-functional linesExperience in successfully leading cross-functional teams to achieve improvementsMust have a demonstrated ability to expand new business, grow client relationships and obtain client referralsMust have strong entrepreneurial business development, negotiation, relationship building, and networking skillsDemonstrated management experience with a focus on customer service, goal setting, and coachingExhibits proven leadership, delegation and project management skillsProven ability to influence without authorityMust be able to share own professional insights, expertise, and knowledge to develop critical thinking across the businessProven leadership skills in direct and matrix reporting structuresCollaborates on planning and executing the sales strategy, involvement in presentations, and participation in client meetings as appropriatePrefers a Pharm D from an accredited college or universityPrefers up to one to two year experience in managed careRequires retail, or other pharmacy experienceBenefitsComprehensive health benefits (Medical/Dental/Vision)Retirement PlansGenerous PTOIncentive PlansWellness ProgramsPaid Volunteer Time OffTuition ReimbursementCompany OverviewHorizon Blue Cross Blue Shield of New Jersey is a company that provides health insurance products. It was founded in 1932, and is headquartered in Newark, New Jersey, USA, with a workforce of 5001-10000 employees. Its website is http://www.horizonblue.com.



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