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.

Best People, Best Solutions, Best Results

Job Summary:

These position will serve as as key personnel for the Services related to Oversight Activities of Medicare Advantage, Prescription Drug Plan, Programs of All-Inclusive Care for the Elderly (PACE), and other related Health Care Organizations contract. These positions will provide support to Pharmacists, Nurses, and/or other Subject Matter Expert as well as other managerial functions in the program. Responsible for facilitating and managing assigned projects and contracts relating. 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. Will serve as a Subject Matter Expert to the client for either Coverage Determination, Appeals and Grievances (CDAG) for Part D or Organizational Determinations, Appeals and Grievances (ODAG).

Required Skills

To perform the job successfully, an individual should demonstrate the following competencies:

· Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses experience to complement data.

· Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully.

· Project Management - Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time; Manages project team activities.

· Leadership - Inspires and motivates others to perform well; effectively influences actions and opinions of others.

· Quality Management - Looks for ways to improve and promote quality.

· Judgment - Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process.

· Planning/Organizing - Prioritizes and plans work activities; Plans for additional resources; Develops realistic action plans.

Required Experience

Education and/or Experience

• Registered pharmacist, Bachelor’s degree in pharmacy, with Master's degree in pharmacy or PharmD. Degree with three to five years’ experience in practice (retail, health-systems, consulting, industry or academia).
• Strong knowledge of the U.S. Food and Drug Administration law, rules and regulations; CMS rules, regulations and guidance; Drug Enforcement Administration law, rules and regulations; National Drug Codes; pharmacy benefit managers; the drug supply chain; clinical reviews; drug invoice reconciliation reviews; on-site pharmacy audits; drug compendia; First Databank; Medi-Span; HCIdea; and National Council of Prescription Drug Programs.

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

To perform the job successfully, an individual should demonstrate the following competencies:

· Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses experience to complement data.

· Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully.

· Project Management - Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time; Manages project team activities.

· Leadership - Inspires and motivates others to perform well; effectively influences actions and opinions of others.

· Quality Management - Looks for ways to improve and promote quality.

· Judgment - Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process.

· Planning/Organizing - Prioritizes and plans work activities; Plans for additional resources; Develops realistic action plans.