Pharmacy RN

Sedgwick

(Irving, Texas)
Full Time
Job Posting Details
About Sedgwick
Sedgwick Claims Management Services, Inc., is a leading global provider of technology-enabled risk and benefits solutions. At Sedgwick, caring countsSM; the company takes care of people and organizations by delivering cost-effective claims, productivity, managed care, risk consulting and other services through the dedication and expertise of more than 14,000 colleagues in some 275 offices located in the U.S., Canada, the U.K and Ireland.
Responsibilities
- Performs clinical assessment via information in pharmacy reports and case files; assesses client's situation to include psychosocial needs, cultural implications and support systems in place. - Evaluates patient drug usage and physician prescribing patterns. - Evaluates overuse, underuse and misuse of prescribed medications and may recommend testing to determine if drug diversion is present. - Evaluates need for and recommends alternative treatment. - Sends letters as needed to prescribing physician(s) and refers to physician advisor as necessary. - Negotiates appropriate level and intensity of care through use of medical and disability duration guidelines, adhering to quality assurance standards. - Negotiates changes in pharmacy plan with providers. - Acts as a resource in consulting with the client, nursing staff and claims examiners regarding pharmacy issues. - Performs drug utilization reviews through the pharmacy benefit manager or vendor. - Communicates effectively with claims examiner, client, vendor, supervisor and other parties as needed. - Maintains client's privacy and confidentiality; promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. - Supports the organization's quality program(s).
Ideal Candidate
Education & Licensing Active RN license(s) required. Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred. Certification in case management, pharmacy, rehabilitation nursing or a related specialty is highly preferred. Experience Two (2) years of direct clinical care OR two (2) years of case management/utilization management required. Skills & Knowledge - Knowledge of pharmaceuticals used to treat pain - Knowledge of behavioral health - Knowledge of pain management process - Knowledge of drug rehabilitation process Knowledge of workers' compensation laws and regulations - Excellent oral and written communication, including presentation skills - PC literate, including Microsoft Office products - Leadership/management/motivational skills - Analytic and interpretive skills - Strong organizational skills - Excellent interpersonal skills - Excellent negotiation skills - Ability to work in a team environment - Ability to meet or exceed Performance Competencies Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking
Compensation and Working Conditions

Working Conditions

When applicable and appropriate, consideration will be given to reasonable accommodations.

Questions

Answered by on
This question has not been answered
Answered by on

There are no answered questions, sign up or login to ask a question

Want to see jobs that are matched to you?

DreamHire recommends you jobs that fit your
skills, experiences, career goals, and more.