[Hiring] Pharmacist SME – Medicare Part D @Pathfinder Group

Role Description

This position is great fit for pharmacists who enjoy working with data and using their strong problem-solving skills. Retail-only experience is not a good fit for this position.
• Support the Client’s Investigations MEDIC contract in the detection and prevention of Medicare Part C and Part D fraud, waste, and abuse.
• Serve as a subject matter expert in assisting auditors, data analysts, and other designated staff conducting data and investigative analysis.
• Lead projects involving the proactive identification of vulnerabilities and data analysis to identify and detect fraud, waste, and abuse.
• Facilitate and manage assigned projects and contracts relating to pharmacy services.
• Lead and provide oversight to assigned tasks and contracts, ensuring contract specifications are understood and tasks are assigned appropriately.

Qualifications
• Registered pharmacist, Bachelor’s degree in pharmacy, with Master's degree in pharmacy or Pharm.D.
• Three to five years’ experience in practice (retail, health-systems, consulting, industry or academia).
• Medicare Part D Plan, managed care plans, or PBM experience strongly preferred.
• Experience in areas such as coverage determination, administration of formularies, auditing claims for payments of pharmacy benefits required.
• Compounding and/or tele prescribing experience is a plus.
• Intermediate-level and above ability to use Excel is required.
• Writing skills sufficient to ensure timely and accurate completion of contract deliverables. A writing sample may be requested.

Requirements
• Active, current and non-restricted Registered Pharmacist (RPh) license in the areas required by the contract.

Company Description