Clinical Pharmacist

CLINICAL PHARMACIST

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Clinical Pharmacist to provide pharmacotherapy expertise in support of the Clinical Pharmacy Programs, Pharmacy and Therapeutics (P&T) Committee, drug formulary, prior authorization and drug utilization review.

The essential duties and responsibilities will include the following: 

• Perform clinical review of Prior Authorizations and Appeal requests for all lines of membership.
• Prepare for bimonthly or monthly Pharmacy and Therapeutics (P&T) meetings (new drug reviews for CA and Medi-Cal formularies, drug class reviews for CA).
• Provide clinical expertise and perform case review in the Clinical Pharmacy Program which includes the Clinical Pharmacy Outreach Program (CPOP – a counter-detailing program), MTM-LTC, Pharmacy Case Review, CMS Star Rating Clinical Initiatives.
• Provide support for the development and maintenance processes of all HPSM formularies for all lines of membership.
• Provide technical help desk support to resolve internal and external inquiries related to pharmacy claims adjudication, benefits, formulary and prior authorization.
• Prepare and provide support in all (onsite and desk) audit activities related to Pharmacy Unit
• Perform intern teaching/preceptor duties through partnership with various institutions.
• Perform other duties as assigned.

Requirements

Education and Experience:  License and Certificates: Licensure as a Pharmacist in the State of California. PharmD from an ACPE accredited college or pharmacy program is required. Equivalent to two years’ work in a clinical pharmacy. Managed care experience is required.

Knowledge of: Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint. Therapeutic drug utilization. Medicare Part D, Medi-Cal and Managed Care programs.

Ability to: Work cooperatively with others. Work as part of a team and support team decisions. Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks Communicate effectively, verbally and in writing. Proficiently use computers and related software applications. Provide effective customer service. Demonstrate sound math, analytical, and problem solving skills

Other: Valid driver’s license, own vehicle, and auto insurance.

Compensation and Benefits

Starting Compensation Range: - Depending on Experience

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage.  Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits.  Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.