Atlanta, GA, United States
Apr 08, 2021
The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk beneficiaries, as defined by CMS, or other beneficiaries in additional projects as determined by business needs.
Are you passionate about helping with issues related to Overutilization while helping patients receive the best care? If so, this could be the right position for you.
The Staff Clinical Pharmacist will be responsible for independently completing timely reviews and decisions of case files for patients obtaining controlled substances, including but not limited to calculating daily morphine milligram equivalent (MME) of current opioid regimen. Further duties include the following.
Will convey passion for assisting prescribers and pharmacists to treat patients who have chronic pain, opioid use disorder (OUD), or substance use disorder (SUD) diagnoses.
Conducts telephonic outreach to providers to discuss therapy regimens and/or concerns, and completes appropriate written documentation of outreach. Communicates with other team members and/or other departments when issues are identified.
Maintains knowledge of emerging drugs of abuse and legislative actions that will impact the Drug Management Program.
Participates in meetings as required. Completes additional clinical programs and projects as assigned.
B.S Pharmacy or PharmD degree from an accredited college of pharmacy
Active, pharmacist license in good standing in state of residence
Ability to participate in Federal prescription programs
3 years of experience as pharmacist
Excellent written and verbal communication skills
Ability to perform mathematical analysis
Proficient with computers (Windows based systems)
Self-directed, but also able to work well with a team
Work ethic that is focused, accurate, and highly productive
Ability to solve problems and encourage others in collaborative problem solving
Ability to communicate with prescribers effectively resulting in optimal patient outcomes
Experience with case management of controlled substances and other drugs of abuse
Completion of pharmacy practice residency and/or board certification
Experience with medication, prescriber and pharmacy lock-in programs
Managed care experience
Moderate experience with Microsoft Excel
- Will require on call evening/weekend rotation to meet business needs
- Ability to travel to meetings as needed (up to 10%)
As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
Scheduled Weekly Hours