[Hiring] Preferred Drug List (PDL) Pharmacist @Gainwell Technologies LLC

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role DescriptionThis role involves supporting the clinical, operational, and financial PDL needs of the Delaware (DE) Medicaid Fee-for-Service line of business. • Manage the implementation, maintenance, and expansion of the Preferred Drug List (PDL) • Ensure adjudication and related communications reflect the latest changes • Monitor drug file-related changes such as new drugs, new generics, and discontinuations • Develop PDL-related prior authorization criteria • Identify needed therapeutic class reviews (TCRs) and assist with their creation and update • Analyze net bolthires comparisons and monitor Client utilization and market share trends • Operationalize the program and identify areas for improvement • Work cross-functionally to implement, update, and maintain PDL-related information in the Pharmacy Services Module Qualifications • PharmD or commensurate experience • 3+ years of experience in pharmacy benefits management or managed care • Experience working in Medicaid, healthcare technology, and/or pharmacy analytics • Deep clinical and operational expertise • Excellent verbal and written communication skills • Ability to abide by Gainwell policies • Ability to maintain attendance to support required quality and quantity of work • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers • Ability to develop, organize, and maintain project plans and agendas Requirements • Excellent public speaking abilities • Proven experience managing formularies from clinical, operational, and financial perspectives • Strong personal computer and business solutions software skills • Proven ability to interact with varied internal and external stakeholders • Proven ability to interface with and manage Account and Client relationships Benefits • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies to help build skills and capabilities Company Description Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.Apply tot his job
Apply Now

Similar Opportunities

Certified PBM Business Integration Specialist (Pharmacist): 9 Months Remote Project: $ 74/hr C2C/1099: $ 69/hr W2.

Remote Full-time

Remote Medication Access Pharmacist

Remote Full-time

Pharmacist, Utilization Management (UM) Remote in MST/PST

Remote Full-time

Acute Care Pediatric Registered Nurse, Remote LA

Remote Full-time

Payroll Administrator, Remote, Payroll, FT, 08A-6:30P

Remote Full-time

REMOTE Pharmacy Technician Job at Actalent in Fort Lauderdale

Remote Full-time

Public Relations Senior Account Manager

Remote Full-time

Pharmacy Technician Pharmacy Service Specialist Remote: North Dakota

Remote Full-time

PRN Paramedic (EMT-P)

Remote Full-time

Medical Chart Reviewer/Donor Eligibility Associate

Remote Full-time

Experienced Part-Time Data Entry Clerk – Remote Online Opportunity at arenaflex

Remote Full-time

Change Management Consultant - OCM (Remote)

Remote Full-time

Remote Part-Time arenaflex Home Advisor: Entry-Level Customer Support Specialist with a Passion for Technology

Remote Full-time

bolthires Fabric Consultant (Architect/Engineer)

Remote Full-time

Chief People & Culture Officer – National Office (Remote)

Remote Full-time

[Remote] Content Specialist

Remote Full-time

Experienced Pharmacy Technician and Data Entry Specialist - Patient-Centric Healthcare and Remote Work Opportunities at arenaflex

Remote Full-time

Graphic Thumbnail Designer (bolthires)

Remote Full-time

Stylus and Optical Profilometry Sales Engineer – US Midwest

Remote Full-time

Remote Non-QM Loan Underwriter- West Coast Only

Remote Full-time
← Back to Home