Program Integrity Pharmacist Position Description:This position is responsible to serve in the Pharmacy Unit to review prescription claim patterns for potential irregularities. Based on their findings they will perform audits and make recommendations to the department for potential recoupment, claims adjustment, and prospective editing; and to support the Pharmacy Director in the management of the OHCA pharmacy programs. PRINCIPLE ACTIVITIES: - Analyzes pharmacy program and recommends interventions for cost-effective use of resources.- Analyzes claims utilization for clinical issues using MMIS, Business Objects, and Excel.
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