Pharmacist

• Maintaining and supporting the Medicare and/or Medicaid formulary
• Providing clinical and economic data for formulary decisions
• Acting as a pharmacy resource for network physicians and health plan members
• Assisting with CMS mandated quality and compliance activities
• Serving as a pharmacy topic educator and training resource

Health Plan Pharmacist

• Assist in accurately reading, interpreting and entering prescriptions into the computer system
• Calculate doses and assign directions
• Accept proper insurance payment in a timely fashion
• Route incomplete or unclear prescriptions to the prescriber for clarification
• Enter incomplete prescription information once clarification has been obtained
• Assist with inbound phone calls; interact with customers and cross-functional team to answer questions, solve problems, provide education, and maintain our company’s reputation for high-quality service
• New patient enrollment, verification of insurance coverage and perform benefit investigations
• Process medication orders for both new and existing patients
• Working knowledge of insurance, health care, reimbursement-related requirements for dispensing, processing of new referrals, and providing customer education, and routine assessment and problem identification with appropriate escalation to a pharmacist

Pharmacy Care Technician

• Perform varied activities and moderately complex administrative/technical/operational/customer support assignments
• Manage daily worklists, conducting follow-ups, and prioritizing authorization requests
• Research and interpret insurance claims while using a broad array of clinical and informational resources
• Work directly with physician offices to initiate and complete prior authorization requests
• Ensure compliance with quality standards and departmental protocols
• Support the delivery of high-quality patient care and operational excellence

Specialty Pharmacy Technician, Prior Authorization

• Provide consultations through the patient's preferred method of communication (text, app messaging, email, or phone)• Perform initial assessments by gathering/reviewing chart notes to determine appropriateness of prescribing patterns• Perform clinical check-ins to monitor adherence, efficacy, adverse reactions, and drug interactions• Identify patients in need of clinical interventions and work collaboratively with providers to provide therapeutic recommendations resulting in improved patient outcomes• Ensure transition of care by transferring out prescriptions to appropriate pharmacies in situations where Alto is unable to fulfill a patient’s prescription• Being responsible for communicating prescription statuses to patients and providers• Work closely with Specialty Operations to provide quality care through the following:• Maintain an in-depth understanding of pharmacy billing including but not limited to Medicaid, Medicare, ADAP, commercial insurance, and foundation assistance programs to help troubleshoot patient cost barriers• Proactively identify and communicate areas of concern regarding scheduling/delivery procedures• Develop and provide drug information material designed to enhance Specialty Operations’ performance• Stay abreast of relevant and evolving regulatory and industry standards, ensure that appropriate action is initiated, and communicate these trends to applicable personnel• Work interactively with a local and/or dispersed team to achieve company business and compliance goals/objectives

Patient Care Pharmacist – Short Term Assignment

• Provides pharmaceutical care to Customers including processing and accurately dispensing prescription orders.
• Counseling Customers regarding health care and prescription medication needs.
• Maintaining confidential information and controlled medication documentation.
• Demonstrates expertise and applies this to the development, execution, and improvement of action plans.
• Supports business solutions by building relationships with stakeholders and monitoring progress.

Staff Pharmacist, Floater

• Provides pharmaceutical care to Customers including processing and accurately dispensing prescription orders.
• Counseling Customers regarding health care and prescription medication needs.
• Maintaining confidential information and controlled medication and required documentation.
• Demonstrating up-to-date expertise and applying this to the development, execution, and improvement of action plans.
• Provides and supports the implementation of business solutions by building relationships with key stakeholders.
• Ensures compliance with Company and legal policies, procedures, and regulations for assigned areas.
• Communicates clear expectations regarding quality of care and patient safety.
• Writes timely and effective plans of action focused on identification and correction of root cause.

Staff Pharmacist – Winslow

• Serve as a trusted advisor providing Pharmacy thought leadership for Employee Benefits at a regional level
• Drive sales and revenue growth by expanding current client relationships and new client opportunities in the mid and large employer market space through RFP participation, onsite or video presentation and one on one consultation
• Communicate strategic and tactical up-to-date pharmacy business initiatives and solutions in a way that allows clients to understand the impacts to their strategy and their employees
• Partner with, train and develop HUB financial consultants, producers and account management personnel to understand and present key Pharmacy findings and solutions
• Provide detailed pharmacy analysis(es) working with the HUB analytics platform along with various partners and PBM's decision support tools to justify the election of the appropriate pharmacy solution
• Provide proactive topical pharmacy communication(s) to HUB internal staff and external clients through a variety of methods including regional or local webinars and seminars
• Represent the National Pharmacy Practice in various strategic business initiatives as appropriate
• Contribute to National Pharmacy Practice team as a collaborative partner and subject matter expert
• Assist in the development of the Pharmacy "practice" and help to implement appropriate changes to our solutions and service(s) to improve client results

Pharmacy Consultant

• Processes prior authorization requests received by phone, fax, or electronically
• Completes prior authorization approvals and denials
• Follows prior authorization workflow, policies, and procedures
• Answers inquiry calls from providers and pharmacies
• Participates in training and continuing education

Pharmacy Technician – Prior Authorization

• Train the resident to become a confident and competent Clinical Pharmacist.
• Deliver pharmaceutical care at the facility and serve as a resource for pharmacy, nursing, and allied healthcare providers.
• Active participation on multi-disciplinary healthcare teams in an area of specialty to provide quality patient care.
• Participation in the optimal selection of drug therapy and designing regimens to maximize therapeutic benefit and minimize toxicity.
• Accountable for on-going evaluation and documentation of all components of pharmaceutical care delivered to patients.
• Conduct educational activities, apply principles of performance improvement, and participate in facility and system committee(s).
• Assess data reflective of the patient’s status and provide pharmaceutical care based on those needs.

Pharmacy Resident, PGY1/PGY2

• Understand and adhere to the National EMR Policies and Procedures Manual, Uniform Handbook, and Operations Manual.
• Foster a culture that encourages team members to work safely, identify potential hazards, and report safety concerns immediately to their direct chain of command.
• Maintain active status within the agency’s platforms, including learning management systems to complete training that may be directed toward self-improvement, mission-specifics, or Just-In-Time (JIT) training.
• Execute assigned pharmacy services for the service population as prescribed by an advanced practice provider or physician and apply best practice guidelines to include but not limited to medication inventory, storage, distribution, and documentation.
• Communicate effectively with health care providers regarding care for service population and be a liaison between pharmacy and medical staff.
• Maintain adequate inventory of all medications/supplies, ensure medications/supplies are within date and properly stored.
• Dispose of all unused and expired medications properly according to established protocols.
• Maintain electronic/paper medical health care records as determined by event/deployment.
• Develop and maintain an accurate medication administration record (MAR) for each client.
• Assist in daily MAR audits, ensuring proper documentation. Reporting all medication errors utilizing chain of command.
• Compile daily medical lists and distribute to all designated staff.
• Maintain first aid kits per licensing standards, if applicable.
• Assist in medication intake/discharge process in collaboration with other medical staff.
• Other duties as assigned.

Pharmacy Technician

• Advocate for members understanding pharmacy benefit options
• Support transition from retail to mail-order services
• Address questions related to pharmacy
• Assist with Rx Education/Enrollment processes and medication research
• Triage calls requiring consultation with pharmacist
• Make outbound calls offering medication therapy management programs
• Schedule medication review sessions with consultative pharmacists
• Document member interactions thoroughly in accordance with compliance standards
• Adhere to scripting protocols while maintaining member-centered conversation style

Consultative Pharmacy Technician 2, Consumer Engagement

• Supports Pharmacists in Specialty Rx medication preparation by dispensing Specialty Rx medications
• Performs varied activities and moderately complex administrative/operational/customer support assignments
• Takes in-bound phone calls from patients and providers
• Enters prescription orders into the system
• Ensures adherence to Specialty Rx specific operational processes and programs developed to optimize health outcomes

Certified Pharmacy Technician

• Complete Clinical Reviews and provide a determination of Medicare-Medicaid Coverage Determination/Redetermination
• Responsible for support and input to clinical programs
• Continually monitor the quality and efficiency of the Prior Authorization process
• Provide input to clinical content of new programs
• Complete all annual NCQA, Aetna required and Quarterly IRR training requirements
• Responsible for supporting / providing clinical expertise related to formulary decisions
• Assist Member Services and other internal customers in responding to pharmacy-related inquiries
• Maintain open lines of communication with other functional areas/departments
• Stay current with clinical literature and guidelines

Clinical Pharmacist – AMA Dual

• Lead a team of account executives, driving strategic and operational excellence
• Build and maintain consultative partnerships with senior client stakeholders
• Oversee budget, revenue goals, staffing, and resource allocation
• Develop and implement standard operating procedures for client service
• Manage contract negotiations and pricing for new business and renewals
• Facilitate strategic discussions with clients to review service performance

Director, Pharmacy Client Management

• The Pharmacist reports to and will be supervised by the Medical Director or his/her designee.
• Deliver services in a secured detention facility and assist in the treatment of patients by dispensing drugs and related medical supplies under the direction of a Physician, Surgeon or other authorized health care professional.
• Ensure the security of prescription drugs and pharmaceuticals and control of the pharmacy inventory.
• Fill prescriptions, verifying instructions from physicians on the proper amounts of medication to be given.
• Manage medication therapy protocols as part of the provider-pharmacist-nurse team.
• Check for patient drug contraindications.
• Verify dosage regimen for accuracy and specified amount to be within the standard dosing range and frequency.
• Compound and dispense medications accurately for delivery to patient care areas.
• Ensure prescriptions are filled accurately and in a timely manner.
• Provide medication information and education to medical staff and patients.
• Participate in medical care conferences as directed by the Medical Director.
• Maintain the security of controlled substances as well as an accurate log of dispensation, waste, etc.
• Maintain adequate stock levels of medications that are high use to include key medications for unforeseen events such as outbreaks.
• Develop a re-supply system with the senior logistician that ensures critical use medications are readily available throughout the medical footprint supported.
• File prescriptions once filled.
• Oversee the work of pharmacy technicians.
• Perform administrative functions such as answering phones and stocking shelves.
• Maintain safe and clean working environment by complying with procedures, rules and regulations.
• Other duties and projects assigned.

• The Consultative Pharmacist 2 consults with patients, pharmacies and providers to provide patient care in the form of optimal medication therapy
• Advises safe, accurate and timely usage of medications
• Designs, implements, evaluates and makes adjustments to medication care plans
• Monitors medication therapy and makes adjustments as needed
• Works as the medication expert in focused proactive heath campaigns that target improving health outcomes for patients with specific conditions

Consultative Pharmacist

• Prepare, dispense, and compound medication under the direct supervision of a licensed pharmacist.
• Provide prescription support services for patients to ensure safe, appropriate, effective and efficient delivery of medication therapy.
• Provide excellent customer service skills, high attention to detail, strong problem solving, documentation and computer skills.
• Work closely with the multidisciplinary healthcare team to support pharmaceutical care activities, complete pharmacy billing activities, record keeping, reporting, inventory management, and arrange appropriate medication delivery.

Retail Pharmacy Technician

• Performs clinical services to optimize drug therapy and documents clinical interventions.
• Provides medication therapy management using medication-related protocols including pharmacokinetics, parenteral nutrition, serum creatinine and other therapeutic drug monitoring by utilizing clinical software and assessing relevant information.
• Advises physicians on use of formulary medications and suggests alternative therapeutic options.
• Provides accurate, clinically relevant drug information to physicians, nurses, and allied health professionals.
• Participates in code arrest response by providing information and assuring availability of medications.
• Identifies, prevents, and investigates potential and real adverse drug reactions and medication errors.
• Provides information required for drug related patient counseling.
• Reviews and interprets physician orders properly; screens for incompatibilities, interactions, duplicates, or contraindications.
• Contacts nursing personnel and/or prescriber regarding any questions on drug orders.
• Dispenses and labels medication orders, including oral medications and IV solutions.
• Competent using various pharmacy technology products such as electronic health records, automated dispensing machines, compounders, unit dosing, tube system, and clinical decision support/data mining tools.

• Provide patient education through telephonic consultations for patients of the specialty pharmacy in accordance with Lumicera’s Patient Management Program.
• The consultations will focus on effective assessment and communication of disease state management, side effect mitigation strategies, administration of medication, appropriate storage, and therapeutic appropriateness, following patient-centered care model.
• Answer clinical questions from patients and caregivers.
• Provide detailed clinical documentation of patient consultations and interventions in pharmacy software system in compliance with internal policies and procedures and external regulatory bodies (such as URAC).
• Contact physicians for new prescriptions, consult with physicians and nurses regarding pharmaceutical questions, and contact pharmacies for prescription transfers.
• Work with physicians to convert prescriptions to generic, biosimilar, or preferred drugs whenever possible.
• Conduct evidence-based research and interpret clinical data in support of Lumicera’s clinical outcomes research program.
• Act in accordance with all applicable federal and state laws and with the highest ethical standards.
• Thus, legal and ethical compliance is an essential duty of each employee.
• Document and report medication errors per company policies and procedures.
• Facilitate error reduction and prevention methods based on quality department and ISMP standards.
• Adapt to new workflows and processes.
• Solve unique pharmaceutical problems.
• Stay current with advancements in specialty pharmacy therapies, including new drug approvals and specialty disease state treatment guidelines.
• Participate in training, workshops, and mentoring opportunities as assigned to expand knowledge.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

Clinical Intern, Specialty Pharmacy

• Support healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues.
• Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures.
• Conduct benefit investigations for patients by making outbound phone calls to payers to verify patient insurance benefit information.
• Verify patient specific benefits and document specifics including coverage, cost share and access/provider options.
• Identify any coverage restrictions and details on how to expedite patient access.
• Document and initiate prior authorization process and claims appeals.
• Report any reimbursement trends or delays in coverage to management.
• Act as a liaison for field representatives, health care providers and patients.

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Health Plan Pharmacist

Pharmacy Care Technician

Specialty Pharmacy Technician, Prior Authorization

Patient Care Pharmacist – Short Term Assignment

Staff Pharmacist, Floater

Staff Pharmacist – Winslow

Pharmacy Consultant

Pharmacy Technician – Prior Authorization

Pharmacy Resident, PGY1/PGY2

Pharmacy Technician

Consultative Pharmacy Technician 2, Consumer Engagement

Certified Pharmacy Technician

Clinical Pharmacist – AMA Dual

Director, Pharmacy Client Management

Pharmacist

Consultative Pharmacist

Retail Pharmacy Technician

Pharmacist

Clinical Intern, Specialty Pharmacy

Patient Access Specialist – Specialty Pharmacy