Pharmacist

Company: kyyba
Location: Detroit
Posted on: February 20, 2025

Job Description:

Title: Pharmacist

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Location: Detroit, MI

Mode: Hybrid (1 day/week onsite)

Duration: 6+ months

Pay range: $55-70/hour



Engagement Overview:

The Clinical Pharmacist is responsible for ensuring efficient utilization of prescription drug benefits by evaluating and influencing prescribing patterns among healthcare providers. This role focuses on optimizing drug utilization review, improving the quality of benefits for members, and reducing unnecessary drug benefit costs. The Clinical Pharmacist serves as a key liaison with the Medical Policy department, contributing to policy development related to pharmaceutical guidelines and formulary management.

Key Responsibilities:

Conduct prior authorization reviews in a Pharmacy Benefit Management (PBM) environment, ensuring compliance with CMS regulations and clinical coverage criteria.
Utilize clinical resources to assess medical necessity, provide drug utilization reviews, and offer evidence-based recommendations.
Educate and collaborate with physicians and healthcare providers to enhance prescribing practices, ensuring cost-effective and high-quality patient care.
Assist in developing and refining medical policies related to pharmaceutical coverage.
Maintain up-to-date knowledge of Medicare/Medicaid regulations, clinical guidelines, and pharmacy benefit management strategies.
Effectively manage multiple tasks, prioritize work, and adapt to changing healthcare regulations and policies.
Leverage Microsoft Office Suite and proprietary systems to document and analyze pharmacy utilization data.

Required Skills & Experience:

Prior authorization experience in a PBM environment with expertise in formulary management.
Strong understanding of CMS regulations, clinical coverage criteria, and drug utilization review processes.
Exceptional ability to prioritize tasks, manage multiple responsibilities, and adapt to evolving healthcare policies.

Education & Certifications:

Bachelor's Degree (RPh) or Doctorate (PharmD) in Pharmacy required.
Current unrestricted Michigan Pharmacy License required.
Minimum three (3) years of experience consulting with physicians on pharmaceutical issues OR completion of an accredited ASHP, AMCP, Managed Care Pharmacy, or Pharmacy Practice Residency.
Experience as a Clinical Pharmacist or Drug Information Specialist preferred.

Keywords: kyyba, Detroit , Pharmacist, Healthcare , Detroit, Michigan