Founded in 1978, Universal Health Services, Inc. (UHS)* is one of the nation's largest and most respected healthcare management companies, operating through its subsidiariesacute care hospitals, behavioral health facilities and ambulatory centers nationwide. With more than 74,000 people employed by UHS subsidiaries, UHS's business strategy is to continue to grow by building or purchasing healthcare facilities across the country, while continuing to strengthen UHS's well-reputed franchise with its customary exceptional service and effective cost control. Our success is driven by a service philosophy based on integrity, competence, compassion, and a responsive management style. UHS has been recognized as a Fortune 500 company and is listed as one of Fortune's Most Admired Companies. UHS's Acute Care Division is comprised of 25 high performing hospitals and several ambulatory care facilities across the nation and prides itself on providing superior patient care.
Prominence Health Plan, established in Reno in 1993 as St. Mary's Health Plan, was acquired in 2014 by Universal Health Services (UHS), one of Fortune Most Admired Companies.
In addition to the HMO, Prominence Health Plan also offers Point of Service health plans, a preferred health insurance company that offers Preferred Provider Organization (PPO) health plans, and CDS Group Health, a third-party administrator.
We are a fast-growing, rapidly-changing healthcare organization offering the excitement of a start-up with the support of a Fortune 500 company. We are looking for talented, enthusiastic people to help shape the future of our organization.
The Clinical Pharmacist executes clinical programs related utilization management, care management, and quality improvement. To do this, this position will have knowledge of pharmaceutical services provided under both the pharmacy and medical benefits. The position will also provide general clinical support to customer service, claims, sales, and other departments across all lines of business including Commercial fully insured, self-insured, and Medicare Advantage products. The position will regularly interface with the pharmacy benefits manager, pharmacies, provider offices, members, brokers, and employer groups. This position will also assist with compliance and business development activities.
Required education: Pharm.D. or BS Pharmacy
Required licensure: Current Nevada and Texas pharmacist licensure in good standing or ability to obtain Nevada and Texas licensure within 6 months of hire
o 3+ years of previous health plan experience, including Medicare Advantage
o 3+ years in pharmacy infusions operations
o Written and verbal Spanish language proficiency
Specialized subject matter expertise in one or more of the following topics required:
Home pharmacy infusions operations
Medicare Part D
Mail Service/Specialty pharmacy
Pharmaceutical benefit design
Other facets of pharmaceutical, managed care, and PBM industries
Proven experience in a customer-facing role.
Excellent communication skills.
Must be able to write effectively
Comfort with both phone and face-to-face communications
Familiarity with the pharmaceutical, managed care, and PBM industries
Familiarity with and ability to quickly learn multiple software tools
Claims Processing Platforms (extensive knowledge required)
Reporting platforms (must be able to write ad hoc queries in at least one reporting tool)
Intermediate level MS Office skills
Universal Health Services