· Complies with relevant Medicaid and Program policies and procedures regarding information, authorizations and communications.
· Dispenses medication advice via interaction with physicians and nurses.
· Interacts with prescribers over the phone: obtains information from prescribers and their delegates regarding clients for whom authorization has been requested, educates prescribers regarding the Peer Review Program, informs prescribers of status of authorization and status of prescription availability at pharmacies, and coordinates sending of missing information and renewal requests to prescribers.
· Coordinates and conducts drug utilization review and reporting: completes authorization decisions and reports status of completions, makes referrals of cases requiring consultation, assures consultations are completed in a timely fashion and resultant actions are appropriately reported, and analyzes specific cases and categorizes drug usage problems.
· Monitors, tracks, and analyzes medication usage and results utilizing a central database. May make recommendations to alter individual medications or provide mental health plan input.
· Reviews and interprets medical orders; provides drug information and recommends drug therapies to physicians.
· Reviews patient medication profiles.
· Provides quality improvement services necessary for accreditation, certification or maintenance of licenses and permits.
· May coordinate programs or projects related to the use and monitoring of medications.
· May dispense and distribute medications