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Managed Care Clinical Pharmacist - Community Health Choice
The Clinical Pharmacist provides highly specialized integrated clinical pharmacy services to the health plan. The Pharmacist will provide drug utilization reviews based on establish protocols for prior authorization and appeal requests, and to provide educational outreach to prescribers as appropriate.The Managed Care Clinical Pharmacist will assist with:Developing prior authorization review criteria for medications covered on pharmacy and medical benefitsConduct oversight over prior authorization criteria and delegated utilization management functions performed by PBMReviewing PBM's formularies to identify improvement opportunitiesCreate and refine policies and standard operating procedur


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