Utilization Management Pharmacist Trainer

Position Summary:
We are seeking a dynamic and experienced pharmacist trainer to join our team. As a pharmacist Trainer, you will play a pivotal role in developing and delivering training programs that enhance knowledge, operational efficiency, and customer service skills to our pharmacist staff. The successful candidate will have a strong background in pharmacy practice, a passion for education and the ability to create engaging and impactful training content.

Position Responsibilities:

* Facilitate the onboarding process for new hires and provide comprehensive training sessions for pharmacists on prior authorization systems, processes, and procedures utilizing a variety of training methods.
* Develop and update training materials, resources, verbiage templates, job aids, and communicate updates to the team.
* Ensure that training content is accurate, up-to-date, clinically relevant, compliant with federal and state regulations, and internal policies.
* Maintain detailed records of training sessions, participant attendance, and training materials for auditing and reporting purposes.
* Assess performance of pharmacists through evaluations, quizzes, and practical assessment to identify areas for improvement and provide constructive feedback.
* Collaborate with pharmacy managers, supervisors, and other relevant stakeholders to identify training needs, performance gaps and ensure alignment with company goals.
* Make clinical prior authorization and appeals determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times.
* Provide detailed and thorough documentation in prior authorization cases, overrides and call center cases.
* Perform peer-to-peer reviews with providers when requested.
* Perform scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to providers.
* Effectively communicate issues and resolutions to members, pharmacies, providers, and appropriate internal stakeholders.
* Provide backup support to call center team as required.

Required Qualifications:

* A Doctor of Pharmacy (Pharm.D.) degree or Bachelor of Pharmacy degree from an accredited pharmacy program.
* An active unrestrictive pharmacist license.
* 3+ years of experience as a clinical pharmacist in Pharmacy Benefit Management (PBM) setting.
* Previous experience developing and delivering training programs.
* Solid understanding of prior authorization operations, Federal and State laws, and regulations.
* Excellent written communication and presentation skills to effectively convey complex information to diverse audiences.
* Excellent analytical skills and attention to detail.
* Ability to collaborate effectively with cross-functional teams and adapt to changing priorities.
* Proficiency in using e-learning platforms, multimedia tools, and Microsoft Office Suite.
* Ability to work a flexible schedule independently with minimal supervision, staying productive in a remote, high-volume, and metric driven call center environment.

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.