Clinical Pharmacist

Job description

FLSA Status : Exempt Department: Pharmacy Reports To : Director of Pharmacy & Utilization Management GENERAL DESCRIPTION OF POSITION: The Clinical Pharmacist supports clinical activities and projects required to meet regulatory and compliance obligations in all lines of business (Medi-Cal and Dual Connect) and to promote overall improvements in the quality of services provided by SCFHP. This position typically reports to the Director of Pharmacy or other appropriate administrator. ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily. Review prior authorization requests delegated to the pharmacy team in the UM queue, ensuring compliance with DHCS and CMS turnaround requirements and supporting the department’s timely review rate goal of over 95%. Develop, implement, and manage pharmacy clinical programs that support Medicare Part D Star measures, HEDIS measures, MCAS performance metrics, and DUE programs, including creating provider and member education materials, conducting outreach calls, writing call-scripts and workflows, and performing outcomes analysis. Serve as the primary...