Pharmacist - Medicare Part D
Work from Home within the Continental United States
@Orchard LLC is supporting 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. Our client has multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Our client is also a national leader in fighting fraud, waste, and abuse for large organizations across the country. In addition, our client operates a foundation providing grant opportunities to those with programs for under-served communities.
We have 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. Retail-only experience is not a good fit for this position. Well qualified candidates will possess strong writing skills as well as intermediate-level or better Excel skills. This position can be home-based in most areas of the continental U.S.
This team of Pharmacists support the Client'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. They are responsible for facilitating and managing assigned projects and contracts relating to pharmacy services. Leads and provides oversight to assigned tasks and contracts, making sure that contract specifications are understood, tasks are assigned appropriately, and information is available and circulated.
Essential Duties and Responsibilities include the following:
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