Pharmacist - PBM Clinical Account Manager
Overview of Position
As part of Change Healthcare's Pharmacy Benefit Administration (PBA) business unit, the PBM Clinical Account Manager will serve as the primary staff clinician, drug information specialist, and Preferred Drug List manager for the PBA's Cabinet for Health and Family Services (CHFS) Kentucky Fee-for-Service (FFS) Medicaid client. The Clinical Account Manager is responsible for preparing clinical reports, drug monographs and preparing and/or presenting information to the various boards and committees. The PBM Clinical Account Manager also assists the data analysts by providing clinical criteria for reporting.
The PBM Clinical Account Manager serves as the account drug information specialist. This position also serves as the subject matter expert for Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codes pertaining to drugs, including the pricing of procedure coded drugs dispensed by non-pharmacy providers such as practitioner offices and outpatient clinic settings. The Clinical Account Manager attends professional association meetings as required; manages clinical call center and other issues related to drug prior authorizations; monitors prior authorization trends and makes clinically and financially sound recommendations to the State. The PBM Clinical Account Manager actively supports prospective and retrospective drug utilization review activities, including reporting. The position acquires, analyzes and maintains information regarding pharmacy benefits management best practices and coordinates lock-in program activities. Position will be based in the CHFS office in Frankfort, Kentucky. Initially, the position may be remote due to Covid-19 restrictions.
What will be my duties and responsibilities in this job?
What are the requirements needed for this position?
What other skills/experience would be helpful to have?
What are the working conditions and physical requirements of this job?
General office demands
How much should I expect to travel?
Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.
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Equal Opportunity/Affirmative Action Statement
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