Medicare PartD Pharmacy Resident

About the Role

The PGY1 Residency Program in Medicare Part D aims to equip and educate residents in all facets of Medicare Part D practice.

Key Responsibilities

• Assist Senior Leadership in planning, development, and implementation of Medicare Part D products, programs, and services, including CMS bid submissions.
• Develop, implement, and maintain utilization management and drug utilization review programs.
• Serve as a key clinical support for processing drug information inquiries.
• Participate in the Pharmacy & Therapeutics committee, providing clinical and financial formulary recommendations.
• Develop, implement, and continually update physician and patient educational materials.
• Collaborate with internal departments to develop sound clinical programs, monitor their effectiveness, and report cost savings.
• Promote appropriate prescribing behavior among BCBSM participating physicians for the Medicare Part D population.
• Propose, plan, execute, and review quality assurance activities related to medication reconciliation, academic detailing, and controlled substance clinical reviews.
• Assist with oversight of the Part D Medication Therapy Management program, including vendor management and MTM program submission to CMS.
• Prepare, review, and conduct presentations and/or continuing education programs for various audiences.
• Assist with internal and CMS audits, and other Part D operational areas.
• Participate in the review of prior authorizations for drugs covered under Medicare Part D and Part B.
• Participate in the development and execution of initiatives to improve Medicare Stars quality measures, focusing on medication adherence.
• Complete a pharmacy research project, including a poster presentation.
• Collaborate with the formulary team on the drug rebate program, formulary development, and the Coverage Determinations, Appeals, and Grievance process.
• Assist with the Part D component of Requests for Proposals from prospective client groups.
• Identify opportunities for improvement in clinical programs based on data analysis.
• Aid in the management of high-cost specialty medications.
• Actively participate in the education of pharmacy students as a lecturer and by precepting interns and students.

Requirements & Tech Stack

• Microsoft Office Suite (Word, Excel, PowerPoint)

Qualifications

• Doctor of Pharmacy degree (PharmD) required.
• PharmD program GPA of at least 3.0 is highly preferred.
• Possess current Michigan Pharmacist License within 90 days of the start of the position.
• Managed care pharmacy work or internship experience is strongly preferred.
• Thorough knowledge and practical application of the principles of evidence-based medicine.
• Proficient in Microsoft Office (Word, Excel, PowerPoint).
• Experienced and confident in communicating with other healthcare professionals.
• Superior oral and written communication skills.
• Expertise in the design of presentations.
• Excellent customer service skills.
• Ability to manage multiple tasks.
• Demonstrated leadership skills.
• Ability to work well in teams and independently.
• Ability to problem-solve and consensus-build.
• Strong commitment to accuracy, especially in communicating clinical information.
• Detail-oriented with excellent organizational and time-management skills.