Houston, United States
4 months ago
Consults with nursing and medical staff on prescription orders, patient reactions, and errors or complaints. Conducts drug utilization reviews and prepares drug review criteria for medical staff approval. PharmD degree preferred.
Review Part D appeal requests by applying utilization management criteria for internal Medical Director review
Review Part D appeal requests to ensure appropriate patient safety such as drug-drug interactions, drug-disease interactions, drug-age precautions, therapeutic duplications, and overutilization in order to put forward the most appropriate recommendation to the Medical Director
Collaboration with healthcare professionals and customers to ensure appropriate clinical data captured in review. Ensure recommendations that are sent to the Medical Director are consistent in order to maintain inter-rater reliability. Assist medical directors and other part D staff with drug information related questions.
Maintaining excellent understanding of evidence based medicine clinical guidelines