Clinical Pharmacist (Part-Time)

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

Clinical Pharmacist (Part-Time - 20 hours a week M-F between 8am - 5pm PST / Pacific)

Position Purpose: Define and develop standard and custom formularies for assigned plan.

• Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated

• Monitor prior authorization requests

• Provide clinical support to internal departments and address clinical related questions

• Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice

• Develop and implement programs designed to impact DUR for both Medicaid and Medicare

• Develop, implement, and maintain policies and procedures for the pharmacy department

• Participate in the coordination of the Medicare MTM program

• Assist case management team with members including clinical rounds presentations

Shift: WFH - 20 hrs. per week between 8am - 5pm (PST / Pacific) Monday -Friday. Flexible on how allocated but there is a strong preference for someone that could evenly spread it out along the week or work at least 2 hours a day.

Will eventually share staffing holidays on-call with rest team.

Job Specific Details:

This position will predominantly process our Medicaid and Health Net Commercial appeals, provider escalations and other miscellaneous clinical Pharmacist functions (Quality, reporting & analysis, compliance deliverables) as secondary to other Staff roles.

• Goal oriented; skilled at task management and ensuring that deliverables are met on time.

• Resourceful and creative; able to assess a problem and develop multiple solutions to address.

• Experience in Managed Care preferred. Requires in-depth knowledge of managed care pharmacy benefit design and an ability to apply medical necessity analysis.

• Prior knowledge/experience with Centene systems preferred. Skilled at use of technology to process appeal requests and navigate systems to find support of clinical determinations

Education/Experience: Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.
Licenses/Certifications: Current state’s Pharmacist license with no restrictions.

* Please attach an up-to-date resume that meets Education / Experience & Licensure requirements above to your application. *

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act