RDTP Assistant Unit Coordinator - Pharmaceutical Systems and Policy - School of Pharmacy

The Department of Pharmaceutical Systems and Policy in the School of Pharmacy at West Virginia University Research Corporation is currently accepting applications for an Assistant Unit Coordinator for the Rational Drug Therapy Program (RDTP).

About the Opportunity

This position is responsible for performing concurrent drug utilization review with program instructions and general pharmacy information using the point-of-sale computer system established by the West Virginia Bureau of Medical Services (WVBMS), PEIA, and WVCHIP. Manages the Human Resource function of the RDTP program. Reviews and manages the information provided to providers by the program's non-professional personnel. Performs the responsibilities of Unit Coordinator when absent. Provides professional services to the WVBMS, PEIA, and WVCHIP when requested or as directed by the Unit Coordinator. Assists the Unit Coordinator with, administrative, planning, budgeting, and other such managerial duties.

At WVU Research Corporation, we strongly believe in work-life balance and keeping time for things we love outside our work. WVU Research Corporation offers a comprehensive benefits package with a variety of options to suit your needs:

• 13 paid holidays ()
• PTO
• 403(b) retirement savings with a fully vested 3% employee contribution match, (Employees have the option of contributing an additional 1-3% of their earnings to the plan, which is also matched by the WVURC)
• A range of
• Dependent Education Scholarship
• WVU Perks
• And More!!

What you'll do:

• Review individual inquiries and use clinical decision-making skills and therapeutic judgment to determine if claim payment can be approved by using the following guidelines:
  • Review patient medication profiles in order to determine the clinical appropriateness of the inquiry, taking into consideration drug-drug, drug-age interactions, duplications of therapy, medical necessity, and other issues which may affect the clinical outcome of the patient. Offer and document explanations for inquiries that cannot be paid.
  • For non-complex requests: use established guidelines and enter approved requests into the mainframe computer.
  • For complex requests: review texts, journals, and/or other references to determine if a claim can be approved. Enter approved requests into the mainframe computer.
  • Offer and document explanations for denials based on current program guidelines and pharmaceutical care issues. Provide alternative recommendations based on anticipated patient outcomes and cost-effective results.
• Management and Supervision
  • Primary Objectives
    
    • Assist with the development and administration of programs, procedures, and guidelines to help align the workforce with the strategic goals of RDTP and WVU.
    • Participate in administrative staff meetings and attend other meetings and seminars when necessary.
    • Assist to establish departmental measurements that support the accomplishment of the company's quality assurance standards and strategic goals.
    • Prepare periodic reports for management, as requested.
    • Assist with the implementation of the performance management system that includes performance review, performance development plans, and employee development programs.
    • Oversee and assist with the establishment of an in-house employee training program that addresses the company's training needs including training needs assessment, expected training progress and performance metrics, new employee orientation or onboarding, management development, production cross-training.
    • Oversee completion of a comprehensive employee handbook.
    • Maintain employee training records.
    • Participate in recruitment and hiring of new staff by participating in hiring committees.
    • Assist with onboarding new employees and providing introduction to policies.
    • Deal with employee relations in conjunction with Human Resources.
  • Organization Development
    • Assist with employee communication and feedback through such avenues as company meetings, suggestion programs, employee satisfaction surveys, newsletters, employee focus groups, one-on-one meetings, and Intranet use.
    • Help monitor the RDTP culture so that it supports the attainment of the RDTP's goals and promotes employee satisfaction.
• Technician Supervision
  • Review inquiries from technical employees of the program and ascertain the clinical appropriateness of the outcome in comparison to the drug utilization evaluation against which the inquiry is being presented. Avert inappropriate outcomes and educate the technical employee where applicable.
  • Supervise the information being released by non-professional personnel to persons making inquiries. This is accomplished by monitoring statements made by the personnel on the phone and by reviewing materials being sent in response to inquiries.
  • Assist in the maintenance of criteria for the PEIA, CHIPS, and WV Medicaid programs.
• Perform the responsibilities of Unit Coordinator when absent.
• Initiate research to gather and evaluate information from various references to perform prospective drug utilization reviews. Demonstrate proficiency in gathering information from various sources including, but not limited to 1) texts and references within the program and University libraries, 2) PubMed online search program, 3) Internet, 4) references which providers and manufacturers present for review. Evaluate the reliability of sources by identifying potentially skewed or biased information.
• Acquire and maintain clinical knowledge and information on the disease states in which the program is involved and on the drug utilization review process as it pertains to disease states in which the program is involved.
• Respond to inquiries in a friendly, professional manner. Accept calls directly or calls routed from other employees where the inquirer demonstrates abusive, belligerent behavior. Make a reasonable attempt to converse constructively with the inquirer. Document all disconnects or other actions. Refer all inquiries outside the scope of knowledge of the program to appropriate sources when and where possible.
• Serve as a source of information about the program to individuals making inquiries. Distribute informational guidelines and provide information to substantiate decisions made by the program to establish credibility for the program and to educate the individual making the inquiry. Compose correspondence on a wide range of subjects relating to the program.
• Administrative Duties
  • Under the supervision of the Unit Coordinator, help oversee RDTP response to the implementation and/or adaptation of prior approval edits. Provide information to Medical providers to enhance the implementation and/or adaptation of such edits.
  • Help with the design, development, implementation, and evaluation of the new or adapted prior authorization program edits to meet the needs and objectives of WVBMS.
  • Help develop strategies for the program.
  • In the absence of the Unit Coordinator, prepare program reports for management, client, or others.
  • Help identify legal requirements and government reporting regulations affecting the program. Help in the preparation of information requested or require for compliance.
  • Under the supervision of the Unit Coordinator, maintain daily operational programs such as, but not limited to, Quality Assurance and Personnel Scheduling.
• Other Duties
  • Participate in and assure the completion of the daily "housekeeping" duties of the program. These include but are not limited to a) daily report, b) faxing, c) data entry, d) comfort issues, e) computer backup/maintenance, etc.
  • Attend meetings where applicable and when staffing allows.
  • Perform other professional duties and/or responsibilities as assigned by RDTP Unit Coordinator.

• Bachelor of Science Degree in Pharmacy or Doctor of Pharmacy Degree.
• A minimum of three (3) years of experience as a licensed pharmacist with retail or hospital pharmacy experience.
• Ability to make valid clinical judgments concerning a patient's drug therapy needs, given the guidelines of the program.
• Excellent verbal and written communication skills.
• Ability to work as a team player and make constructive suggestions to appropriate peers and supervisors.
• Excellent customer service skills and orientation.
• Excellent skills in handling difficult persons.
• Knowledge of appropriate drug in most common disease states.
• Strong understanding of retail pharmacy operations and insurance billing processes associated with retail pharmacy operations.
• Excellent computer data entry, software (Window's based), and typing skills.
• Ability to follow guidelines and convey information in an accurate manner.
• Flexibility and the ability to work with different insurance plans with different guidelines.

• Registered/Licensed Pharmacist in WV or Eligible for Registration/Licensure in WV.

The WVURC was created as a not-for-profit corporation in 1985 to support research (R1) at West Virginia University. We provide evaluation, development, patenting, management, and marketing services for inventions of the faculty, staff and students of the University.

The WVURC receives and administers funds awarded by external agencies for research and other activities and is responsible for helping protect intellectual property through patents, copyrights and licensing agreements for start-up companies based on University research.

Creating an inclusive, engaged, and dynamic environment is core to WVURC's mission. We welcome candidates who can contribute a range of ideas, approaches and experiences.

West Virginia University Research Corporation is proud to be an Equal Opportunity employer. We value diversity among its employees and invites applications from all qualified applicants regardless of race, ethnicity, color, religion, gender identity, sexual orientation, age, nationality, genetics, disability, or Veteran status.