Medicare Pharmacy Resident #20-1930

<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, MI

Emergent Holdings

<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>

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Competitive Compensation and Benefits Package

Overview: The purpose of the Medicare PGY1 residency program is to empower and educate the resident in all areas of Medicare pharmacy practice, including but not limited to: <ul> <li> Formulary Management (including rebates)</li> <li> Pharmacy 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> Pharmacy Care Management</li> <li> Administration and Leadership</li> </ul>
Responsibilities: <ul> <li> Assist Senior Leadership in the planning, development, and implementation of Medicare pharmacy 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 & 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 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 Parts D and 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 Medicare pharmacy 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> <li> Other duties as assigned</li> </ul>
Requirements: EDUCATION: <ul> <li>Doctor of Pharmacy degree required.</li> <li>PharmD program GPA of at least 3.0 is highly preferred</li> <li>Must possess current Michigan Pharmacist License within 90 days of start of position</li> </ul> EXPERIENCE: (Minimum experience necessary to perform this position) SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: <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>Managed care pharmacy work or internship experience is strongly preferred</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> <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>Other related skills and abilities may be required</li> </ul> WORKING CONDITIONS: Work is performed in an office setting with no unusual hazards.&nbsp;