Genesis10 is currently seeking a Clinical Coding Pharmacist with a Major Healthcare Company located in Minnetonka, MN. This is a 3+ month, REMOTE, contract opportunity.
Pay Range: $55.00 - $60.00 per hour based on experience and qualifications
Position Overview:
The Clinical Coding Pharmacist on the Clinical Coding Consulting team serves as the primary liaison between the client's Formulary & Utilization operations, Benefit Operations Management, and the Clinical Consultant. This role provides clinical coding support for clinical consultants, benefit operations management (BOM), information technology, and other internal departments. The ideal candidate will provide custom formulary and utilization management coding consultation for setup in the RxClaim adjudication system and related formulary management applications.
Primary Responsibilities:
- Provide consultative guidance for standard and custom formulary changes in RxClaim, RxBuilder, and related clinical applications
- Conduct second-level formulary and UM claim research
- Implement clinical coding support for cBDT questions
- Provide GPI reclassification support, global coding change support, and drug utilization management support
- Provide commercial clinical audit support
- Manage custom formulary coding work following client sign-off
- Translate client intent into codable language for the BOM team
- Evaluate and resolve new rule designs and conflicts with existing formulary coding
- Provide coding support for custom formulary and UM programs during new client implementations
- Extract, evaluate, and interpret clinical coding within adjudication and formulary management systems
Core Requirements:
- Bachelor of Science in Pharmacy or PharmD
- Current and unrestricted Pharmacist license (any U.S. state)
- 2+ years of experience working as a Clinical Consultant or Clinical pharmacist working in Formulary/UM operations or Benefit administration
- Experience conducting claims/coding research and analysis
- Experience working within a PBM
- Experience working in RX Claim or other claims adjudication systems
- Intermediate to Advanced proficiency with Microsoft Excel
- Proven ability to navigate MS Office and a Windows-based environment, and the ability to create, edit, save, and send documents utilizing Microsoft Word; ability to navigate Outlook and conduct Internet searches
Desired Skills:
- MBA or other related advanced business degree
- Experience using Microsoft Access or other database/query tools
- Experience with Medi-Span drug classification system
- Client-facing experience (beyond patients and prescribers)
If you have the described qualifications and are interested in this exciting opportunity, please apply!
Ranked a Top Staffing Firm in the U.S. by Staffing Industry Analysts for six consecutive years, Genesis10 puts thousands of consultants and employees to work across the United States every year in contract, contract-for-hire, and permanent placement roles. With more than 300 active clients, Genesis10 provides access to many of the Fortune 100 firms and a variety of mid-market organizations across the full spectrum of industry verticals.
For contract roles, Genesis10 offers the benefits listed below. If this is a perm-placement opportunity, our recruiter can talk you through the unique benefits offered for that particular client. Benefits of Working with Genesis10:
- Access to hundreds of clients, most of whom have been working with Genesis10 for 5-20+ years
- The opportunity to have a career home in Genesis10; many of our consultants have been working exclusively with Genesis10 for years
- Access to an experienced, caring recruiting team (more than 7 years of experience, on average)
- Behavioral Health Platform
- Medical, Dental, Vision
- Health Savings Account
- Voluntary Hospital Indemnity (Critical Illness & Accident)
- Voluntary Term Life Insurance
- 401K
- Sick Pay (for applicable states/municipalities)
- Commuter Benefits (Dallas, NYC, SF, and Illinois)
For multiple years running, Genesis10 has been recognized as a Top Staffing Firm in the U.S., as a Best Company for Work-Life Balance, as a Best Company for Career Growth, for Diversity, and for Leadership, amongst others. To learn more and to view all our available career opportunities, please visit us on our website www.genesis10.com.
Genesis10 is an Equal Opportunity Employer. Candidates will receive consideration without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
#INDGEN10
