Clinical Pharmacist - Formulary Authorization

Summary

Clinical Pharmacist reviews medication requests that require prior authorization, ensuring they meet formulary, safety, and clinical criteria. They evaluate restricted or high-cost drug requests, verify guideline compliance through chart review, identify safer or more cost-effective alternatives, and work directly with providers to approve, deny, or recommend appropriate options.

Duties

Conducts critical review of all Prior Authorization Drug Requests (PADRs) for the medical center. Monitors daily PADR volume and timing, coordinating with supervisors to ensure timely adjudication. Manages all appeal and brand-only requests and tracks each case through completion. Reviews PADR reports and ensures quarterly data corrections are completed. Applies the organization's formulary, guidelines, and restrictions to all PADRs under review. Develops criteria for use when none exist, based on Pharmacy Benefits Management monographs, formulary guidance, and drug information. Reviews and applies criteria for use for each requested medication or supply. Analyzes and incorporates relevant published medical literature into PADR adjudication. Collaborates with procurement technicians to ensure optimal resource use and communicate changes in drug availability. Strives to deliver optimal drug therapy while balancing medication or supply availability and cost. Documents PADR adjudications and formulary-related activities in the electronic health record in a timely, professional manner. Communicates with providers, pharmacists, and staff throughout the adjudication process to provide input and feedback as needed. Coordinates with relevant stakeholders when reviewing, commenting on, and adjudicating PADRs. Serves as a resource for clinical pharmacists and providers regarding formulary status and requirements for restricted or non-formulary medications. Participates in discussions on formulary, restricted, and non-formulary use to support evidence-based, cost-effective therapy. Promotes compliance with the medical center's formulary and drug utilization guidelines. Supports adjudication and procurement processes for specialty-medication PADRs. Provides assistance with Risk Evaluation and Mitigation Strategy (REMS) program requirements. Supports activities related to the investigational drug program. Applies LEAN principles to improve workflow and infrastructure, including developing quick orders and menus. Participates in onboarding new informatics tools and programs as needed across the facility. Participate in training and in-servicing for medical staff, nursing staff, residents, students, and other allied health professionals. Instruct patients and family members on proper use of medications and medical devices. Serve as a preceptor for pharmacy students and residents as needed. Assist with new employee orientation. Help develop proposals for improved or new clinical pharmacy services. Participate in and attend staff development presentations for pharmacy personnel. Maintain a clinical faculty appointment at the University of New Mexico College of Pharmacy. Evaluate prescribers' medication orders for appropriateness and verify/finish pending inpatient orders. Enter or finish outpatient prescriptions for dispensing. Work Schedule: Monday to Friday, 8:00AM - 4:30PM Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Requirements

You must be a U.S. Citizen to apply for this job. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Must be proficient in written and spoken English. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Complete all application requirements detailed in the "Required Documents" section of this announcement. As a condition of employment for accepting this position, you will be required to serve a 1 or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship. Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. Graduate of an Accreditation Council for Pharmacy Education (ACPE) accredited College or School of Pharmacy with a baccalaureate degree in pharmacy (BS Pharmacy) and/or a Doctor of Pharmacy (Pharm.D.) degree. Verification of approved degree programs may be obtained from the Accreditation Council for Pharmacy Education, 20 North Clark Street, Suite 2500, Chicago, Illinois 60602-5109; phone: (312) 664-3575, or through their Web site at: http://www.acpe-accredit.org/. (NOTE: Prior to 2005 ACPE accredited both baccalaureate and Doctor of Pharmacy terminal degree program. Today the sole degree is Doctor of Pharmacy.) Graduates of foreign pharmacy degree programs meet the educational requirement if the 2 graduate is able to provide proof of achieving the Foreign Pharmacy Graduate Examination Commission (FPGEC) Certification, which includes passing the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and the Test of English as a Foreign Language Internet Based Test (TOEFL iBT). Licensure. Full, current and unrestricted license to practice pharmacy in a State, Territory, Commonwealth of the United States (i.e., Puerto Rico), or the District of Columbia. The pharmacist must maintain current registration if this is a requirement for maintaining full, current, and unrestricted licensure. A pharmacist who has, or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions in VA Handbook 5005, Part II, Chapter 3, section B, paragraph 16. English Language Proficiency. Pharmacists must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: In addition to the basic requirements, the following criteria must be used when determining the appropriate grade assignment of candidates. GS-12 Clinical Pharmacist Education and Experience. 1 year of experience equivalent to the next lower grade (GS-11), or Completion of an ACPE-accredited PharmD. Program. Demonstrated Knowledge, Skills, and Abilities (KSAs). Knowledge of professional pharmacy practice. Ability to communicate orally and in writing to both patients and health care staff. Knowledge of laws, regulations, and accreditation standards related to the distribution and control of scheduled and non-scheduled drugs and pharmacy security. Skill in monitoring and assessing the outcome of drug therapies, including physical assessment and interpretation of laboratory and other diagnostic parameters. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Walk, sit and/or stand for extended periods. Lift, carry or move cartons of approximately 30 lbs. Push or pull medication delivery carts of varying sizes

Education

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. How You Will Be Evaluated

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members. Other Information

During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.