Clinical Programs Pharmacist (Opioid\/DUR)

Louisville, Kentucky

Posted in Insurance
9 days ago

This job has expired.

Job Info


The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk beneficiaries, as defined by CMS, or other beneficiaries in additional projects as determined by business needs.


Are you passionate about helping with issues related to Overutilization while helping patients receive the best care? If so, this could be the right position for you.

The Staff Clinical Pharmacist will be responsible for independently completing timely reviews and decisions of case files for patients obtaining controlled substances, including but not limited to calculating daily morphine milligram equivalent (MME) of current opioid regimen. Further duties include the following.

  • Will convey passion for assisting prescribers and pharmacists to treat patients who have chronic pain, opioid use disorder (OUD), or substance use disorder (SUD) diagnoses.
  • Conducts telephonic outreach to providers to discuss therapy regimens and/or concerns, and completes appropriate written documentation of outreach. Communicates with other team members and/or other departments when issues are identified.
  • Maintains knowledge of emerging drugs of abuse and legislative actions that will impact the Drug Management Program.
  • Participates in meetings as required. Completes additional clinical programs and projects as assigned.
Required Qualifications
  • B.S Pharmacy or PharmD degree from an accredited college of pharmacy
  • Active, pharmacist license in good standing in state of residence
  • Ability to participate in Federal prescription programs
  • 3+ years of experience as pharmacist
  • Excellent written and verbal communication skills
  • Ability to perform mathematical analysis
  • Proficient with computers (Windows based systems)
  • Self-directed, but also able to work well with a team
  • Work ethic that is focused, accurate, and highly productive
  • Ability to solve problems and encourage others in collaborative problem solving
  • Ability to communicate with prescribers effectively resulting in optimal patient outcomes
Preferred Qualifications
  • Experience with case management of controlled substances and other drugs of abuse
  • Completion of pharmacy practice residency and/or board certification
  • Experience with medication, prescriber and pharmacy lock-in programs
  • Managed care experience
  • Moderate experience with Microsoft Excel
Additional Information

- Will require on call evening/weekend rotation to meet business needs

- Ability to travel to meetings as needed (up to 10%)

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

Scheduled Weekly Hours


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