Pharmacist

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.

Best People, Best Solutions, Best Results

Job Summary:

Qlarant has an opportunity for a Pharmacist with Medicare Part D experience preferably in a Managed Care/Provider Benefit Manager setting. This position will support the Program Audits conducted by the Centers for Medicare and Medicaid Services. The ideal candidate will have experience with Medicare Formulary Administration and/or Medicare Part D Coverage Determinations, Appeals and Grievances. This position can be home-based in most areas of the continental US. They will be responsible for facilitating and managing assigned projects and contracts relating to pharmacy services. Leads and provides oversight to assigned tasks and contracts, making sure that contract specifications are understood, tasks are assigned appropriately, and information is available and circulated.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Prioritizes and accomplishes tasks and programs independently and in a team to ensure successful implementation of goals and objectives.
• Works with the appropriate stakeholders to build partnerships, support data sharing, and develop tools and references to support changes in care practices in the pharmacy arena.
• Reviews and interprets contract deliverables to ensure timely and accurate completion.
• Contributes to the conceptual design and implementation of projects, as well as assists with project execution as needed.
• Ensures all project deliverables and timelines are met and reports on variances in a timely manner.
• Testifies at various legal proceedings or administrative hearings, when subpoenaed.
• Provides educational programs, as necessary, to meet project goals. Contributes professional presentations at pharmacy, medical, and quality organization meetings.

To perform the job successfully, an individual should demonstrate the following competencies:

• Business Expertise- Basic understanding of how own department integrates within the Business Area.
• Problem Solving- Uses judgment based on the analysis of information.
• Nature of Impact- Direct impact by ensuring the quality of the tasks/services/information provided by self and others.
• Area of Impact- Primarily on an department.
• Interpersonal Skills- Developed communication and diplomacy skills used to direct/persuade/influence others.
• Leadership- Mentors junior team members.
• Functional Knowledge- In-depth understanding of concepts and principles in own discipline and basic knowledge of these elements in other disciplines.
• Project Management- Senior project/program team member responsible for work flow which is varied in nature with situations frequently requiring new solutions.

Education and/or Experience:

• Bachelor's degree in pharmacy with 8-11 years experience required, Work Experience (experience can be substituted for education)
• Master's degree in pharmacy or PharmD with 12-14 year experience preferred.
• Medicare Part D Plan or PBM, and/or previous CMS Program Audit experience strongly preferred.

Certificates, Licenses, Registrations:

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

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.