Remote Pharmacist II | Work from Home

Job Overview

We invite dedicated and knowledgeable Pharmacists to join our esteemed team as a Pharmacist II, primarily working with the Nevada Division of Health Care Financing and Policy (DHCFP). This full-time contract role presents an exceptional opportunity to utilize your clinical expertise to enhance healthcare access for the Nevada Medicaid population.

Key Responsibilities

• Conduct comprehensive clinical reviews of medical and outpatient pharmacy utilization management criteria and cases, using your clinical judgment in alignment with program policies and regulations.
• Assess drug prior authorization (PA) exception requests and appeals, formulating policies grounded in clinical guidelines.
• Carry out audits of the pharmacy benefit across Fee-for-Service and Managed Care Organizations (MCOs).
• Testify at appeals hearings, analyze cost offsets, and provide insights on rebate program modifications.
• Aid in the administration of the pharmacy benefit, examining utilization trends to propose benefit design enhancements.
• Oversee formulary management, which includes developing clinical pharmacy utilization management criteria and making cost-related decisions.
• Contribute to the establishment and implementation of clinical quality assurance initiatives.
• Offer clinical support and guidance to internal departments.
• Facilitate the creation and presentation of drug monographs, executive summaries, therapeutic class evaluations, and medication policies.
• Analyze claims data and trends to assess benefit design, identify inappropriate utilization, and suggest improvements.
• Supervise the administration of the Preferred Drug List (PDL) and evaluate its impact on drug expenditures.
• Undertake additional related responsibilities as assigned.
  
  

Required Skills

• Doctor of Pharmacy (PharmD) degree or an equivalent qualification.
• A current, valid Pharmacist license in good standing in any state.
• A minimum of two years of experience in clinical, managed care, health plan, or pharmacy benefit management.
• Proficiency in reviewing drug literature, clinical trial data, and electronic database information.
• A robust clinical and analytical background, particularly with specialty medications (preferred).
  
  

Qualifications

• Doctor of Pharmacy (PharmD) degree or equivalent education.
• A valid Pharmacist license in good standing in any state.
• Minimum of two years’ experience in clinical, managed care, health plan, or pharmacy benefit management.
  
  

Career Growth Opportunities

This position offers significant potential for professional development and advancement within a reputable organization, emphasizing the importance of continuous learning and skill enhancement.

Company Culture And Values

Our organization is committed to fostering a supportive and innovative environment, where clinical expertise is valued, and employees are encouraged to contribute to meaningful healthcare solutions.

Networking And Professional Opportunities

Joining our team provides access to a robust professional network, promoting collaboration and the exchange of ideas among peers in the healthcare industry.

Compensation And Benefits

• Highly competitive salary (up to $74/hour).
• Regular work hours with flexibility in scheduling.
• Hybrid work model (in-office in Carson City or Reno, with remote work options).
• W2 contract position.
• Comprehensive benefits package for full-time employees, including health, dental, and vision insurance.
• Paid time off, with annual increases.
• Reimbursement for continuing education and professional development.
• Complimentary professional liability insurance.
  
  

Employment Type: Full-Time