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Vacancy Search (VPOS)
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HEALTH CARE SERVICES, DEPARTMENT OF
Title: PHARMACEUTICAL CONSULTANT II, DEPARTMENT OF HEALTH SERVICES (SPECIALIST) |
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Job Description: If you are interested in this position, please submit your application to the address listed and reference your list or transfer eligibility. Please include a copy of your exam results with your state application. Duty Statement - Pharmaceutical Consultant II (Spec) Job Summary: The Pharmaceutical Consultant (PC) II Specialist (Spec) is the specialty level in this series. The duties and responsibilities of the PC II include those of the PC I. Percent of Time - Essential Functions 50% Serves as the Pharmacy Section technical expert and specialist on the Department’s SURGE application. Instructs and acts as a lead to the PC Is with any SURGE-related issues. Develops policies and procedures on the administration of the SURGE application, coordinates its dissemination to the PC Is and provides technical training required for implementation. Analyzes legislation and makes recommendations to the Department’s SURGE management team. 20% Provides consultation and SURGE expertise to PC Is. Ensures accuracy and consistency in the application of approved Medi-Cal criteria and regulations. Ensures that SURGE program policies and procedures are uniformly applied, that the adjudication process is done thoroughly, that comments made back to providers are clearly stated, and that decisions are logical and clinically sound. This extensive process involves collecting and analyzing rather large sample each month of the actual SURGE TARs and reviewing for accuracy and consistency with established policies and procedures. The incumbent provides additional training to PC staff, whose work does not meet the Section’s expectations and criteria. 10% Identifies and assesses complex problems, and develops solutions such as, changes made to the contract drug list which alters the way in which providers are billed for services. Serves as liaison with beneficiaries and providers, resolving issues and providing information and referrals as appropriate. Issues and problems that arise are difficult and complex, requiring the high level of knowledge and expertise possessed by a PC II (Specialist). 10% Interprets and applies Departmental policies and standards as they pertain to pharmaceutical benefits of the program. Prepares position statements in response to Fair Hearing requests by beneficiaries of the program. May evaluate, prepare and/or review responses to appeals and Fair Hearings. 5% Oversee operational procedures to assure efficient and effective use of field office staff in processing TARs via the SURGE application. Also reviews specialized TARs which require high levels of training and expertise, such as Serostim, Synagis, Revatio, Durable Medical Equipment and related supplies. Percent of Time - Marginal Functions 5% Acts as Departmental representative on Qualification Appraisal Panel interviews of candidates for employment as PC Is. Additional Information:
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