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Pharmacy Nurse

Employer
CorVel Corporation
Location
Dublin, Ohio
Salary
Not Specified
Closing date
Oct 1, 2019

View more

Category
Health and Medical
Job Type
Full Time
Career Level
Not Specified

Job Details

JOB SUMMARY:

The purpose of this position is to bring the experience, knowledge, and status of a registered nurse to the pharmacy services department. The pharmacy nurse will provide clinical support for our medication prior authorization process and assist the clinical pharmacist with escalated pharmacy reviews.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

  • Handle escalation of flagged claims regarding medication usage by claim, using clinical modelling data of Morphine Equivalency and Pharmacy Risk scores to ensure the needs of CorVel’s clients and their claimants are met.
  • Ensure short-term use adherence for pain medications. Work with treating prescribers, nurse case managers and adjusters to explore and recommend alternative pain solutions on a case-by-case basis, flagging those cases signaling possible dependency issues.
  • Work with the Formulary Support team to define, update and support the standard workers’ compensation and auto formularies.
  • Review prior authorization requests for non-formulary medications.
  • Requires continuous learning using relevant knowledge, keeping up-to-date with new medications/therapies and upcoming brand to generic changes.
  • Provides an overall plan and assist in the conversion of brand and combination drugs to their generic, singular components.
  • Increase the return rate of Letters of Medical Necessity by contacting the prescribers and being the contact person for clinical questions. Also assists in reviewing Letters of Medical Necessity.
  • Monitors pharmacy alert reports to identify and manage “at risk” claimants and communicates findings to clients.
  • Additional duties as required.
  • Requires regular and consistent attendance.

KNOWLEDGE & SKILLS:

  • Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
  • Ability to interface with all levels of staff, physicians and their representatives, and advisors/clients and coworkers.
  • Excellent written and verbal communication skills.
  • Ability to meet designated deadlines.
  • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
  • Strong interpersonal, time management, and organizational skills.
  • Ability to work both independently and within a team environment
  • Experience with Pharmacy Claims Management systems preferred.

EDUCATION/EXPERIENCE:

  • Bachelor’s degree required, BSN desirable.
  • Current RN Licensure in state of operation
  • Workers’ Compensation Experience preferred.
  • Strong pharmacology experience preferred.
  • Valid driver’s license and good driving record with no traffic violations
  • Strong cost containment background, such as utilization review or managed care preferred.

Application Instructions:

We are an Equal Opportunity Employer. All persons shall have the opportunity to be considered for employment without regard to their race, color, age, sex, gender, religion, national origin, ancestry, citizenship status, physical or mental disability, military service, veteran status or any other characteristic protected by applicable federal, state or local law.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this application or to participate in an interview, please let us know.

Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes.

Please be aware that CorVel generally does not review all applications/resumes submitted in response to job openings posted on the Internet because of the large volume of responses

Company

CorVel is looking for passionate, motivated individuals to join our team of associates and help us be successful by making a positive impact within our organization and for our clients. If you are interested in joining CorVel, review our available opportunities and submit your resume as indicated by the application instructions.

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