Managed Care Pharmacist
Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.
The Managed Care Pharmacist -Level I is primarily responsible for the operational review of pharmacy medical exception/prior authorization requests, the communication to members and providers on the outcome of these requests, training of new staff in this process, support of the Plan's care management teams and/or the pharmacy customer care center as pharmacy benefit references. They will also assist in the support and leadership of the Managed Care Pharmacy Technicians and Pharmacy Benefit Specialists as they work to resolve point of sale pharmacy issues.
QUALIFICATIONS:
Bachelor's degree in Pharmacy from accredited school required.
Current NYS pharmacy license in good standing required.
Minimum three (3) years of pharmacy experience that has involved interaction with patients, providers and other healthcare professionals required.
Experience with managed care pharmacy principles including prior authorization reviews, formulary management, and utilization review preferred.
Experience with Microsoft Office, including Word, Excel, and Outlook is required.
Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.
Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.
Demonstrated ability to work with and maintain confidential information.
Excellent verbal and written communication skills.
Flexibility to adapt to a changing and fast-paced environment.
Participate in on-call pharmacy rotation schedule which will include scheduled hours on Friday evenings and possible Saturday hours if necessary.
CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.
CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits at https://www.cdphp.com/about-us/jobs/benefits.
As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.
CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC.
Apply Now
The Managed Care Pharmacist -Level I is primarily responsible for the operational review of pharmacy medical exception/prior authorization requests, the communication to members and providers on the outcome of these requests, training of new staff in this process, support of the Plan's care management teams and/or the pharmacy customer care center as pharmacy benefit references. They will also assist in the support and leadership of the Managed Care Pharmacy Technicians and Pharmacy Benefit Specialists as they work to resolve point of sale pharmacy issues.
QUALIFICATIONS:
Bachelor's degree in Pharmacy from accredited school required.
Current NYS pharmacy license in good standing required.
Minimum three (3) years of pharmacy experience that has involved interaction with patients, providers and other healthcare professionals required.
Experience with managed care pharmacy principles including prior authorization reviews, formulary management, and utilization review preferred.
Experience with Microsoft Office, including Word, Excel, and Outlook is required.
Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.
Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.
Demonstrated ability to work with and maintain confidential information.
Excellent verbal and written communication skills.
Flexibility to adapt to a changing and fast-paced environment.
Participate in on-call pharmacy rotation schedule which will include scheduled hours on Friday evenings and possible Saturday hours if necessary.
CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.
CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits at https://www.cdphp.com/about-us/jobs/benefits.
As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.
CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC.
Apply Now