Meridian

  • Pharmacist

    Job Location US-MI-Detroit
    Job ID
    2018-5463
    Category
    Pharmacy
    Business Line
    MRx
  • Overview

    Who we are:

    MeridianRx is a full-service Pharmacy Benefit Manager (PBM) committed to driving down costs and elevating quality. Our clients experience better quality outcomes, thanks to effective clinical support, patient education, and specialty pharmacy programs.

     

    We work with a diverse range of clients, from members to healthcare providers to plan administrators. MeridianRx services clients across the country and our network continues to grow. 

     

    Our employees work hard, play hard, and give back. MeridianRx employees enjoy: Happy hours, special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.

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    A Day in the Life of a Pharmacist:

    This position is responsible for providing clinical pharmacy services for MeridianRx.  Coordinates the distribution of clinical drug and disease information and educates providers and staff regarding appropriate use of pharmaceutical treatment regimens.

    Responsibilities

    • Improves quality of service to members by providing prior authorization of formulary drugs, developing programs to provide optimal pharmaceutical care to patients, participating in dispute resolution of drug utilization review, measuring and documenting improvements in patient care, and/or improving claim adjudication for proper provider reimbursement
    • Collaborates with other medical management team members in developing treatment guidelines and demonstrates the impact of these guidelines
    • Participates in the maintenance of the non-formulary exception program
    • Participate and review in the utilization management process, including authorizations, denials and appeals. 
    • Participates in formulary development and management
    • Monitors prescribing patterns of participating physicians.  Makes recommendations to physicians to improve medication regimens as appropriate.
    • Participates in the development and maintenance of processes that incorporate pharmacy data and clinical information obtained in the pharmacy authorization process into client Healthcare Effectiveness Data and Information Set (HEDIS) reporting
    • Responds to provider and member questions regarding the pharmacy benefits program.
    • Assist with drug recall and alert communication and safety program.
    • Assists with the preparation and distribution of communication materials between the plan and participating providers
    • Assists the pharmacy care coordinator with drug information and review of complex cases.
    • Participates in the preparation of state-required reports for review and submission at the Pharmacy and Therapeutics Committee meetings
    • Perform MTM to our Clients members.
    • Perform other duties as assigned

    Qualifications

    What you can bring to MeridianRx:

    • Bachelor’s in Pharmacy is required.
    • PharmD or graduate degree is required.
    • Residency and/or Board Certification is preferred
    • Current unrestricted Pharmacist and Controlled Substance licenses in the designated state and in good standing are required.
    • One to two years of experience in managed health care or pharmacy programs is required.
    • Knowledge of the National Committee for Quality Assurance (NCQA), URAC or general accreditation standards for managed care organizations as they relate to pharmacy programs and delegation
    • Knowledge of pharmacy utilization management processes and documentation
    • Familiar with clinical program components, formulary designs, and prescription drug benefit trend

     

    What MeridianRx can offer you:

    • Healthcare benefits that include a variety of plans, which are effective on the first day of employment for our new full-time team members. 
    • Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
    • 401k matching that is above the national average. 
    • Full-time MeridianRx employees are eligible for tuition reimbursement towards Bachelor’s or graduate degrees.
    • A bright and engaging company culture; the Meridian family of companies has been recognized as one of Metro Detroit’s Best and Brightest Companies to Work For 5 years in a row. 

    Equal Opportunity Employer

    #MSTR

     

     

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