Medicare PartD Phrmcy Resident

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

Southfield, USA

Emergent Holdings

<p class="p1"><strong>Emergent Holdings is driven by a singular goal &mdash; improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions, and services to support our key stakeholders &mdash; individuals, employers, providers, and strategic partners &mdash; improving the health and safety of the people and places we serve.</strong></p>

keywords: job description,work environment,assist,review,support,planning,collaboration,other duties,education & experience,skills


Competitive Compensation and Benefits Package

Overview: <br /> <p>The purpose of the Medicare Part D PGY1 residency program is to empower and educate the resident in all areas of Medicare Part D practice, including but not limited to:</p> <ul> <li>Formulary Management (including Rebates)</li> <li>Pharmacy and Regulatory Compliance and Audit</li> <li>Pharmacy Benefits Management</li> <li>Clinical Pharmacy Programs</li> <li>Plan Performance and Quality Assurance</li> <li>Medicare Part B and D Prior Authorizations and Appeals</li> <li>Product Development</li> <li>Administration and Leadership</li> </ul> <br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office setting with no unusual hazards.&nbsp;</p>
Responsibilities: <br /> <ul> <li>Assist Senior Leadership in the planning, development, and implementation of Medicare Part D products, programs, and services such as submission of the CMS bid.</li> <li>Help to develop, implement and maintain utilization management and drug utilization review programs.</li> <li>Serve as a key clinical support person for processing drug information inquiries.</li> <li>Participate in the Pharmacy &amp; Therapeutics committee, making both clinical and financial formulary recommendations.</li> <li>Develop, implement and continually update physician and patient educational materials.</li> <li>Work with various internal departments to develop sound clinical programs as well as monitor and report effectiveness and overall cost savings related to these programs.</li> <li>Promotion of appropriate prescribing behavior among BCBSM participating physicians for the Medicare Part D population.</li> <li>Propose, plan, execute, and review quality assurance activities related to medication reconciliation, academic detailing, and controlled substance clinical reviews.</li> <li>Assist with oversight of the Part D Medication Therapy Management program, including vendor management and MTM program submission to CMS.</li> <li>Prepare, review and conduct presentations and/or continuing education programs to various audiences, including providers and internal pharmacy and medical staff.</li> <li>Assist with internal and CMS audits, and other Part D operational areas, such as transition monitoring and 1/1 readiness.</li> <li>Participate in the review of prior authorizations for drugs covered under Medicare Part D and Part B.</li> <li>Participation in the development and execution of initiatives to improve the Medicare Stars quality measures, especially focusing on medication adherence programs.</li> <li>Completion of a pharmacy research project, including a poster presentation.</li> <li>Collaborate with the formulary team to help with the drug rebate program, formulary development, and the Coverage Determinations, Appeals, and Grievance process.</li> <li>Assist with the Part D component of Requests for Proposals from prospective client groups.</li> <li>Identify opportunities for improvement in clinical programs based on data analysis.</li> <li>Aid in the management of high-cost specialty medications.</li> <li>Actively participate in the education of pharmacy students, both as a lecturer at the Wayne State University College of Pharmacy, and by precepting pharmacy interns and students on rotation.</li> </ul>
Requirements: <br /> <p><strong>EDUCATION:</strong></p> <ul> <li>Doctor of Pharmacy degree required.</li> <li>PharmD program GPA of at least 3.0 is highly preferred.</li> <li>Possess current Michigan Pharmacist License within 90 days of start of position.</li> </ul> <br /> <p><strong>EXPERIENCE:&nbsp;</strong></p> <ul> <li>Managed care pharmacy work or internship experience is strongly preferred.</li> <li>Thorough knowledge and practical application of the principles of evidence-based medicine.</li> <li>Must be proficient in Microsoft Office (Word, Excel, and PowerPoint).</li> <li>Must be experienced and confident in communicating with other health care professionals.</li> </ul> <br /> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Must have superior oral and written communication skills and expertise in the design of presentations.</li> <li>Excellent customer service skills.</li> <li>Ability to manage multiple tasks.</li> <li>Demonstrated leadership skills and ability to work well both in teams and independently.</li> <li>Ability to problem-solve and consensus-build.</li> <li>Strong commitment to accuracy, especially in the communication of clinical information.</li> <li>Detail-oriented with excellent organizational and time-management skills.</li> </ul>