University Health
TX
POSITION SUMMARY/RESPONSIBILITIES Responsible for the administration of pharmaceutical services to CFHP members for all lines of business. Implements decisions set forth by the CFHP Pharmacy & Therapeutics Committee. Evaluates medication utilization and prior authorization requests for medications available via the pharmacy benefit and the medical benefit including specialty ambulatory injectable and/or infusion medications as related to member benefits, medical necessity, site of service, and evidence based clinical guidelines. The Population Health Management Pharmacist functions in a clinical role supporting the development and integration of clinical care models for chronic conditions in collaboration with departments across the health plan. Applies critical thinking, clinical knowledge, evidence-based policies, procedures and clinical guidelines to collaborate with health plan departments to promote quality improvement and care coordination. Adheres to all Federal,...