Partnership HealthPlan of California

Clinical Pharmacist

Job Locations US-CA-Fairfield
Job ID
2025-3406
FLSA Status
Exempt
Hiring Range
$156,741.30 - $203,763.69

Overview

To review Treatment Authorization Requests (TARS)/Coverage Determination Form (CDF) to promote safe, appropriate, and cost-effective drug therapy. Communicates and educates prescribers and dispensing pharmacies on TAR process, TAR determination, and PHC formulary. Participates in P&T meetings and formulary management.

Responsibilities

  • Performs drug Treatment Authorization Requests (TARs).
  • Provides oversight to the pharmacy technician staff in the daily TAR/CDF review process and to assure that PHC’s Prior Authorization Guidelines are properly applied.
  • Communicates with prescriber and dispensing pharmacies on the determination of their submitted TAR and provide information on formulary alternatives and/or what is required for the TAR to be approved.
  • Participates in formulary management, drug utilization, development of technician drug review guidelines, and creation of authorization criteria of non-formulary drugs.
  • Makes recommendation for additions, changes, and deletions to the PHC’s drug formularies.
  • Participates in assigned projects, in-services, academic detailing, and precept pharmacy students.
  • Participates and works with other departments on cross-departmental initiatives that require Clinical Pharmacy input/participation.
  • Other duties as assigned.

Qualifications

Education and Experience

Bachelor’s degree in Pharmacy; minimum of two (2) years of experience in a managed care plan, hospital, or corporate pharmacy entity with duties comparable to those listed above and experience in administering pharmacy programs.

 

 

Special Skills, Licenses and Certifications

Valid CA Pharmacist License required. Knowledge of Medi-Cal program as it relates to pharmacy services. Familiarity with local medical and pharmacy communities preferred. Knowledge of current treatment guidelines and familiarity with online medical and pharmacy information resources. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.

 

 

Performance Based Competencies

Must process clinical information to derive a TAR determination and understand when it is necessary to escalate the review to a medical director. Ability to handle multiple tasks simultaneously and remain cognizant of the daily TAR queue and the need to be compliant with timeliness.

 

 

Work Environment And Physical Demands

More than 80% of work time is spent in front of a computer monitor. Must be able to work in a high pace and high intensity environment.

 

 

 

All HealthPlan employees are expected to:

 

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

 

 $156,741.30 - $203,763.69

 

IMPORTANT DISCLAIMER NOTICE

 

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

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