What are the responsibilities and job description for the Managed Care Pharmacist position at Capital District Physicians Health Plan Inc?
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 is primarily responsible for the duties and responsibilities of 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 as pharmacy benefit references, support and leadership of the managed care pharmacy technicians and pharmacy benefit specialists as they work to resolve point of sale pharmacy and after hour issues .
Qualifications :
- Minimum of a Bachelor's degree in Pharmacy from accredited school and current NYS pharmacy license in good standing required.
- Minimum three (3) years of managed care experience that has involved interaction with patients, providers and other healthcare professionals. Knowledge of managed care pharmacy principles including medical exception reviews, formulary management, and utilization review required.
- Licensed to practice pharmacy in the State of New York is required.
- Working knowledge of PCs, including Microsoft Suite is required.
- Demonstrated ability to identify, analyze and solve problems related to pharmacy services is required.
- Participation in an on-call rotation and holiday rotation.
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.
