• Pharmacy Specialist - casual

    Job ID 2019-3341
    Job Locations
    US-TN-Nashville
    Category
    Healthcare / Biotechnology
    Type
    Casual
  • Overview

    NCI is a leading provider of enterprise solutions and services to U.S. defense, intelligence, health and civilian government agencies. Coupled with a refined focus on strategic partnerships, we are successfully bridging the gap between commercial best practices and mission-critical government processes. Core competencies include:

    • Artificial intelligence
    • Agile digital transformation
    • Advanced analytics
    • Hyperconverged infrastructure solutions
    • Cyber security and information assurance
    • Fraud, waste and abuse
    • Engineering and logistics

    MF18

    NCI has been designated a 2018 Military Friendly Employer by MilitaryFriendly.com 

     

    Headquartered in Reston, Virginia, NCI has approximately 2,000 employees operating at more than 100 locations worldwide.

    Responsibilities

    ESSENTIAL FUNCTIONS:

     

    • Extensive knowledge of how prescription drugs are developed and managed
    • Experience in the development of plans and the review of claims/medical records to ensure clinically appropriate utilization, including experience in claims analysis, claims data review for abnormalities, auditing of claims/medical records to ensure proper utilization of benefits
    • Experience concerning the current uses of medications, new or emerging issues, issues related to electronic prescribing, among other general knowledge and experience in prescription drug benefits
    • Assists the DOJ/AUSA attorneys, DOJ Medical Reviewers and DOJ Supervisor by researching Medicare and Medicaid pharmaceutical drug coverage criteria, regulations and policies as requested
    • Stays current with Medicare and Medicaid fraud/abuse issues or vulnerabilities related to pharmaceuticals and recommends appropriate proactive analysis
    • Assists Statistician with data analysis requests from the customer for pharmaceutical related issues
    • Assists the DOJ team in cases related to pharmaceutical claims
    • Assists the DOJ Medical Review team in the review of pharmaceutical claims
    • Develops and conducts internal and external training as assigned by management
    • Assists with training for internal and external stake-holders
    • Provides expert witness testimony as required
    • Travels as required for meetings or training
    • Conducts research on pharmacy related algorithms as requested to identify clinical implications of the algorithm
    • Conducts state-specific research for applicable pharmacy policies as requested
    • Demonstrates knowledge and ability to research standard pharmacy practices, and Medicare/Medicaid rules and policies for the applicable states
    • Performs other duties as assigned by Operations Manager that contribute to various – task order area – goals and objectives and comply with DOJ directives
    • Ensures confidentiality of all Protected Health Information (PHI) and sensitive information
    • Demonstrates communication skills with internal and external customers, including Senior Management and DOJ/AUSA Attorneys

    Qualifications

    MINIMUM REQUIREMENTS:

    • Bachelor’s Degree of Pharmacy and shall be a board-trained certified pharmacist and trained in Biochemistry, Chemistry and Pharmacokinetics
    • At least five (5) years experience in prescription drug benefit management with three (3) years experience managing a prescription drug formulary, medication therapy management, and drug interaction program

     

     EXPERIENCE REQUIRED:

    • 4 - 9 Years

      

    PREFERRED EDUCATION AND EXPERIENCE:

    • Doctorate of Pharmacy (Pharm. D) preferred

     

    PHYSICAL REQUIREMENTS:

     

    This position requires the ability to perform the below essential functions:

    • Sitting for long periods
    • Standing for long periods
    • Ambulate throughout an office
    • Ambulate between several buildings
    • Stoop, kneel, crouch, or crawl as required
    • Repeatedly lift and carry weight up to _25__ pounds
    • Travel by land or air transportation _5__ %

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