SME Pharmacist III - Medicare Part D

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.

Qlarant has an exciting opportunity for a Pharmacist with Medicare Part D experience preferably in a Managed Care/Provider Benefit Manager setting. Experience related to Medicaid, fraud investigation, medical testimony, law enforcement referrals or investigations, and/or compounding and wholesalers/inventory management is preferred as well. This position is great fit for pharmacists who enjoy working with data and using their strong problem solving skills and will possess strong writing skills as well as intermediate-level or better Excel skills. Our Pharmacists support Qlarant's Investigations MEDIC contract in the detection and prevention of Medicare Part C and Part D fraud, waste, and abuse. This position will serve as a subject matter expert in assisting auditors, data analysts, and other designated staff conducting data and investigative analysis. The Pharmacist may lead projects involving the proactive identification of vulnerabilities and data analysis to identify and detect fraud, waste, and abuse. This position can be home-based in most areas of the continental US.

• Prioritizes and accomplishes tasks and programs independently and in a team to ensure successful implementation of goals and objectives.
• Works with the appropriate stakeholders to build partnerships, support data sharing, and develop tools and references to support changes in care practices in the pharmacy arena.
• Reviews and interprets contract deliverables to ensure timely and accurate completion.
• Contributes to the conceptual design and implementation of projects, as well as assists with project execution as needed.
• Ensures all project deliverables and timelines are met and reports on variances in a timely manner.
• Testifies at various legal proceedings or administrative hearings, when subpoenaed.
• Provides educational programs, as necessary, to meet project goals. Contributes professional presentations at pharmacy, medical, and quality organization meetings.

• Business Expertise- Basic understanding of how own department integrates within the Business Area.
• Problem Solving- Uses judgment based on the analysis of information.
• Nature of Impact- Direct impact by ensuring the quality of the tasks/services/information provided by self and others.
• Area of Impact- Primarily on an department.
• Interpersonal Skills- Developed communication and diplomacy skills used to direct/persuade/influence others.
• Leadership- Mentors junior team members.
• Functional Knowledge- In-depth understanding of concepts and principles in own discipline and basic knowledge of these elements in other disciplines.
• Project Management- Senior project/program team member responsible for work flow which is varied in nature with situations frequently requiring new solutions.

• PharmD required
• Active, current and non-restricted Registered Pharmacist (RPh) license in the areas required by the contract.

• Minimum of 5-7 years experience
• Minimum 8-11 years minimum preferred