The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology Staff Utilization Management Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
The Oncology Staff Utilization Management Pharmacist completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns. Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes, as needed. Acts as the oncology clinical subject matter expert for all clinical support functions within Humana Clinical Pharmacy Review (HCPR). Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Must have an active license with the Board of Pharmacy in the appropriate state.
Pharmacy degree from an accredited college of pharmacy.
Ability to participate in Federal prescription programs.
Self-directed, but also able to work well in a group.
Ability to solve problems and encourage others in collaborative problem solving.
Work ethic that is focused, accurate, and highly productive.
Excellent communication skills.
Excellent computer skills including Microsoft Word, Outlook, PowerPoint & Excel.
Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10 panel drug test.
Must have accessibility to high speed DSL or cable modem for a home office (satellite internet service is NOT allowed for this role); and a minimum internet connection speed of 10M x 1M
Able to work 8 hour shifts Monday thru Friday 9-5:30 PM EST and every fifth Saturday.
Preferred Qualifications
Completion of PGY2 oncology residency
Pharm.D.
Strong organizational skills and ability to stay on schedule. Brings an attention-to-detail approach (strong tactical execution)
Ability to multi-task, manage competing priorities and operate effectively within a large and complex organizational structure.
Experience developing and delivering presentations on clinical and business topics
Experience training health care professionals to care for cancer patients
Ability to work in a fast-paced environment with a focus on quality and production metrics.
Managed Care experience preferred but not required.
Additional Information
#HCPRPharmacy
#LI-Remote
Additional Information
Interview Format:
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected, you will receive correspondence inviting you to participate in a Modern Hire assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 15 - 20 minutes. Your answers will be reviewed and you will subsequently be informed if you will be moving forward to next round.
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.
According to Humana's COVID-19 policy, vaccination and masking is required regardless of vaccination status (with exception for eating and drinking) for associates working in a clinical setting where patients receive care (e.g., pharmacy retail locations, clinics, home care). The policy only requires the primary series alone (first and second vaccine). Boosters are encouraged, but not required. Associates have the option to request an accommodation for medical, religious or other personal needs.
Please note: Some areas of our business, such as the Primary Care Organization including CenterWell, Conviva, Kindred at Home, onehome, SeniorBridge, Neighborhood Centers, Pharmacy Distribution Centers and others, may be required to adhere to federal, state or local or additional workplace guidelines
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
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