Formulary Operations Pharmacist
CurrentManage operational aspects of business unit, department, and strategic initiatives, projects, and/or programs. Focus on efforts of the MedImpact Formulary Maintenance Team in quality control and analysis of MedImpact client formulary set-up, rule sets, coding, accuracy, functionality, EOB, documentation and concordance with client specified and regulatory requirements utilizing distinct but inter-related management and cross-departmental functions. Promote rational and appropriate drug use in the Medicare population and provide direct client clinical consultation relative to Part D formulary drug placement, appropriate utilization management edits and related client specific Word documents for Step Therapy and Prior Authorization Guidelines required by CMS. Ensure appropriate, accurate and consistent client specific Part D formulary claims adjudication, formulary flat file and Plan Finder file concordance and will provide direct client consultation on all Formulary Services formulary maintenance operations, programs, and software. Coordinates quality control and analytics related to the Part D MedImpact Standard and Custom formularies Formulary Change process including appropriate formulary content, application of utilization management activities, printed formularies, Plan Finder formulary files and other functions. Ensure that the review, coding and quality control of formulary changes occur in an appropriate, accurate, and timely manner based on client-specific parameters.