Remedi SeniorCare

Clinical Service Center Pharmacist

US-OH-Troy
Job ID
2017-1457
Functional Area
Clinical Services Center

Overview

Remedi SeniorCare is one of the nation’s TOP TEN long term care pharmacies. We offer nursing homes and assisted-living facilities everything they need to provide better care to their residents by delivering highly responsive pharmacy solutions.

 

Remedi SeniorCare is currently looking for enthusiastic, motivated and talented individuals to join its Pharmacy Operations team. Our Pharmacy delivers life-saving medications to thousands of residents every day. Our team members enjoy climate-controlled state-of-the-art facility equipped with customer-inspired innovative technologies.

 

Remedi offers great benefits and perks!

  • Health, Vision and Dental Insurance
  • Flexible Spending and Health Savings Account
  • Life insurance/Long-and Short-term disability.
  • 401K plan

Responsibilities

Works in collaboration with the Director, Clinical Service Center to execute day-to-day operational needs, including clinical review of rejected claims, recommending clinically appropriate covered alternative medication, overseeing the processing of Automatic Therapeutic Interchange (ATI) recommendations and meeting the requirements of the Clinical Service Center. Adheres to the company’s quality and customer service standards, policies and procedures, and state and federal guidelines in the LTC pharmacy to ensure quality production, work flow and achieving operational goals and objectives.

 

Essential Responsibilities:

  1. Responsible for oversight clinical claim reject activity
  2. making appropriate clinically comparable, formulary alternative recommendations
  3. review approve clinical documentation associated with prior authorization submissions
  4. Provides CSC technicians instructions regarding actions to be taken when working with insurance plans and internal / external customers to take steps toward rejected claims resolution
  5. Works in conjunction with other LTC departments ensuring achieving daily volume, quality and service goals
  6. Communicates with customers, insurance companies and internal pharmacy staff to effectively and appropriately resolve rejected clinical claims
  7. Maintains organized record of CSC documentation related to ATI or claims management
  8. Applies superior customer service skills when working with both internal and external customers
  9. Works in collaboration with the CSC Technicians and Director to meet department goals and objectives.
  10.  Provides assistance in the development, deployment and management of department and customer supported initiatives
  11. Assists with ensuring safety practices and procedures are adhered to and practiced.
  12. Enforces all company and departmental policies and procedures.
  13. Complies with all applicable state and federal regulations related to pharmacy practices.
  14. Customer Focus - Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in products and services; talks and acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect.

Other Responsibilities:

 

    1. Perform related duties and special projects as required or assigned.
    2. Participates in special projects to identify and implement operational improvements. Ability to work with others in a positive productive manner anticipates and responds to the positions areas of responsibilities. Contribute to a positive work environment and overall team effort.
    3. Actively contributes to the evaluation and continuous improvement of LTC pharmacy services, policies and procedures.
    4. Other duties as assigned or directed.

Qualifications

Requirements:

  • Degree in Pharmacy is required, PharmD preferred.
  • License in the state of Ohio required.
  • Licensure in additional states may be required as necessary based on future activity/requirements of the position. 
  • Strong computer knowledge and skills in report development using MS Word, Excel, and PowerPoint required. 
  • Minimum of 3 years working in healthcare environment as licensed pharmacist in LTC Pharmacy or related environment; formulary / clinical expertise preferred, especially related to Medicare Part D

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