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Clinical Pharmacist - Health Plans
Responsible for managing and coordinating the Formulary processes for the various lines of business within the Health Plans. Conducts coverage determination reviews for potentially complex patient cases and for any potential denials in conjunction with pharmacist/prior authorization team. Conducts Medication Therapy Management (MTM) reviews and interventions as appropriate in conjunction with MTM Program. Assists with review and preparation of documentation for Health Plan's Pharmacy and Therapeutics (P&T) Committee, including preparation/collection of monographs for new drug reviews.
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
Current unencumbered Oregon pharmacist license required.
Two (2) years clinical pharmacy experience involving patient interaction preferred.
Medicare Part D, Medicaid and prior managed care pharmacy experience preferred.
Health plans experience strongly preferred.
Time: Full time
Updated: 9/14/2021 4:02:36 PM
Samaritan Health Services Recruiting Department