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NEOGOV · 5 hours ago

Pharmacist 2 - Human Services-BMS - Kanawha Co.

Kanawha County, WV

Full-time

Onsite

Mid, Senior Level

$78K/yr - $118K/yr

4+ years exp

NEOGOV is seeking a Pharmacist 2 for the Human Services Bureau for Medical Services. The role involves developing pharmacy policies, interacting with medical and pharmacy providers, and overseeing drug utilization review processes.

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Responsibilities

This position involves the development of pharmacy policy and interaction with medical and pharmacy providers, agency personnel and the public regarding these policies

Working with the fiscal agent to ensure that claims are processed according to established policies and that data from the system is reported correctly and available for program management

Work with Rational Drug Therapy program to implement established policy and provide information for other department task forces when requested

Work with the pharmacy director on implementation of the preferred drug list and work on its maintenance and reviewing changes and recommendations from the PDL vendor

Provision of staff support and oversight of the quarterly meetings of the drug utilization review board and monthly meetings of the retrospective drug utilization review committee, to develop criteria for the appropriate utilization of drugs and to review member profiles to ensure that criteria is developed for all appropriate therapeutic classes and that current treatment guidelines are employed

Interaction with Medicaid providers, other departments, and pharmaceutical company representatives to explain established policies

Most of this interaction requires a response in writing

Responses are an average of ninety calls per month, many of which require a follow-up response by letter or email

Oversight of pharmacy lock-in program for Medicaid members who may use or divert controlled substances

Establishment of policies to control inappropriate use of controlled substances

Interaction with Medicaid fraud, surveillance and utilization review units, and Medicaid providers for minimization of over utilization and diversion of drug supplied by the Medicaid program

Performs other duties as assigned