PEHP Health & Benefits is a division of the Utah Retirement Systems that proudly serves Utah’s public employees through high quality and competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis. As a government entity, we embrace both a public mission and a commitment to creating customer value, excelling in the market, and improving healthcare. We offer a competitive salary with generous benefits, personal development in a positive team environment, and excellent work-life balance. For most jobs, remote work is available for 9 out of every 10 workdays.
POSITION SUMMARY
A pharmacist who performs administrative duties related to the monitoring, planning, organizing, and managing of the PEHP Pharmacy benefit. Serves as a pharmacy benefits expert, interprets and communicates benefits and programs, pre-authorization and appeal approvals and denials with physicians, members and PEHP employees. Directly involved in the functions of the Pharmacy and Therapeutics Committee.
ESSENTIAL DUTIES & RESPONSIBILITIES
MINIMUM QUALIFICATIONS
Education and Experience
Doctor of Pharmacy Degree from an ACPE accredited school of pharmacy. Minimum of three years of progressively responsible pharmacy experience.
Previous experience within a managed care organization is preferred.
Course work or degree in areas of Business Management, Health Administration, Health Financing and Insurance Management is desirable.
Currently licensed to practice pharmacy in the state of Utah required with a clean licensing history record without infractions.
Must be able to obtain unrestricted certificates with the Drug Enforcement Agency.
Knowledge, Skills, and Abilities
Requires considerable knowledge of drugs and drug prescription practices; considerable knowledge of PBM processes, pharmacy claims adjudication policies, procedures and processes; intricacies related to drug pricing, usage, dosage and drug definitions and codes, formulary practices, pharmacy electronic systems; and researching methods.
Must have the ability to draft technical reports, documents, manuals and instructions; analyze a variety of management issues and problems and make recommendations and decisions; communicate effectively verbally and in writing; ability to follow written and verbal instructions; establish and maintain effective working relationships with professionals, executives (public and private), department management, co-workers and the public; work independently and deal effectively with stress caused by work load and time deadlines.
Job duties require occasional travel for office business. Individual must be physically capable of safely operating a vehicle, possess a valid license and have an acceptable driving record based upon data provided by a current Department of Motor Vehicle Record (MVR).
Work Environment
Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.
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