{"code":"01296","codeVariants":["01296","1296"],"title":"PHARMACEUTICAL CONSULTANT","variant":null,"jurisdiction":"S","class_of_service":"N","work_week":"NL","state_class_code":"28","local_class_code":null,"salary_range":"P28","note":null,"salaryInferred":false,"synthetic":false,"syntheticReason":null,"full_description_html":"<b>PHARMACEUTICAL CONSULTANT</b>\n\n<b>DEFINITION:</b>\n\nUnder the direction of a Medical Consultant, Chief Pharmaceutical Services or \nother supervisory official, as a licensed Pharmacist, is responsible for provision \nof pharmaceutical consultative services required to implement the pharmaceutical \nservices aspects of all department programs including Medicare, Medicaid, and \nPAAD programs; ensures pharmaceutical services provided by the department \nmeet all applicable regulatory and legal requirements as set forth by State and \nfederal agencies; does other related duties as required.\n\n<b>NOTE:</b> The examples of work for this title are for illustrative purposes only. \nA particular position using this title may not perform all duties listed in this \njob specification. Conversely, all duties performed on the job may not be \nlisted.\n\n<b>EXAMPLES OF WORK:</b>\n\nProvides professional pharmaceutical consultant services and oversight of \nthe pharmaceutical services aspect of the health services program in the \nregion or area designated by the department.\n\nDevelops appropriate provider communications through newsletters, alerts, \nand remittance advice messages, as they apply to the administration of \npolicies and procedures related to department pharmaceutical services.\n\nConfers with pharmacists and providers of medical supplies and equipment \nrelative to interpretation of the program.\n\nProvides consultation to staff and providers regarding medical supplies and \ndurable medical equipment.\n\nRefers items requiring prior approval, authorization, or review which cannot \nbe acted on locally due to possible conflict of interest to the district office \ndirector or designee to arrange for a final disposition.\n\nProvides consultation to professional and clerical staff assigned to assist with \nutilization review as auditing of pharmaceutical services furnished by eligible \nrecipients.\n\nIdentifies and maintains a roster of local medical-surgical supplies for use by \neligible recipients.\n\nReviews financial analyses performed by the contracted agent for the \nmaintenance of financial projections and rate setting for the NJ Medicaid \nprogram.\n\nEstablishes and maintains liaison and interprets the pharmaceutical services \naspect of the Medicaid program to staff of the Medicaid District Offices, staff \nof the County Welfare Boards or agencies, and staff of district offices of the \nDepartment of Children and Families; provides consultation and advice \naccordingly.\n\nEstablishes and maintains liaison and interprets the pharmaceutical services \naspect of the Medicare Part D program to staff of the County Offices on Aging; \nprovides consultation and advice accordingly. \n\nReviews Managed Care Organization (MCO) formulary updates and \npharmacy-related contractual issues regarding beneficiary access to \npharmaceutical benefits.\n\nAssists beneficiaries and pharmacy providers with the coordination of \nbenefits between Medicare Part D, Third Party Liability, Medicaid, and \nother state/federal programs; assesses Medicare Part D formulary \nlimitations to maximize coordination of benefits for beneficiaries.\n\nCollaborates in the development of State Plan Amendments and submits \nrequired annual reporting for the Centers for Medicare and Medicaid \nServices (CMS).\n\nConfers with pharmacists and peer review committees of local Pharmaceutical \nAssociations regarding all aspects of the pharmaceutical services program and \nparticipates in evaluating questionable practices, complaints of pharmacists \nand/or recipients, or unusual cases.\n\nOversees the NJ Drug Utilization Review Board (DURB), its protocols, and \nstandards for the State's claims processing system for pharmaceutical services.\n\nPerforms activities in accordance with department/division policies and \nprocedures to promote effective monitoring and control of appropriate utilization \nof pharmaceutical services; collaborates with the department, state auditors, and \nstate/federal fraud divisions to provide information and reports.\n\nParticipates with department/division staff in the further development, analysis, \nand evaluation of policies, procedures, and methods of providing pharmaceutical \nand health services to recipients; responds to legislative proposals containing \npharmaceutical-related issues for the State.\n\nContinuously reviews the quality and quantity of pharmaceutical services \nprovided to Medicaid recipients and others who receive department services by \nevaluation of printouts or profiles of recipients, pharmacists, and/or prescriptions \nto determine evidence of abuse, overuse, and/or appropriateness of services; \nconducts onsite inspections of prescriptions, invoice costs of pharmaceuticals, \nmedical supplies, and equipment to determine adherence to price or costing \nprovisions of the Health Services Program.\n\nRecommends to the pertinent department/division official suggested changes \nin policies and procedures based on local operational experiences.\n\nServes as subject matter expert (SME) for all state and federal pharmaceutical \nassistance programs, including but not limited to Medicare Part D, \nPharmaceutical Assistance to the Aged and Disabled (PADD), and Medicaid; \nserves as the state SME and liaison for the development, modification, and/or \nreplacement of management information systems for Medicaid, PADD, and \nother pharmaceutical programs.\n\nParticipates in training programs for staff members of the department/division \nconcerning the pharmaceutical services aspect of the Medicaid Program and \nother programs administered by the department and its agencies.\n\nParticipates in appeal hearings concerning pharmaceutical providers as well \nas recipients.\n\nWill be required to learn how to utilize various types of electronic and/or manual \nrecording and information systems used by the agency, office, or related units.\n\n<b>REQUIREMENTS:\n\nEDUCATION:</b>\n\nGraduation from an accredited college, university, or School of Pharmacy with \na Doctor of Pharmacy degree.\n\n<b>EXPERIENCE:</b>\n\nFour (4) years of experience as a Registered Pharmacist which shall have \nincluded two (2) years of experience with a large public health program, \nhealth carrier, hospital, and/or retail pharmacy.\n\n<b>LICENSE:</b>\n\nPossession of a valid license as a Registered Pharmacist issued by the \nState of New Jersey.\n\nAppointees will be required to possess a driver's license valid in New Jersey \nonly if the operation of a vehicle, rather than employee mobility, is necessary \nto perform the essential duties of the position.\n\n<b>KNOWLEDGE AND ABILITIES:</b>\n\nKnowledge of pharmaceutical practices and procedures.\n\nAbility to organize assigned work, analyze pharmaceutical and related \nproblems, and develop effective work methods.\n\nAbility to work as a member of a team designed to improve pharmaceutical \nservices provided to welfare recipients and the medically needy in the state.\n\nAbility to understand and interpret established pharmaceutical procedures \nin relation to specific cases.\n\nAbility to provide technical assistance to department staff.\n\nAbility to establish and maintain liaison between department facilities including \ndistrict offices and local Pharmaceutical Society or societies and the staff of \nCounty Welfare Boards or agencies.\n\nAbility to conduct conferences with peer review and other committees.\n\nAbility to effectively monitor and control appropriate utilization of \npharmaceutical and health services to recipients.\n\nAbility to conduct onsite inspections of prescriptions and medical supplies \nand equipment.\n\nAbility to make recommendations to pertinent department/division officials.\n\nAbility to participate in training programs for staff members.\n\nAbility to maintain essential records and files.\n\nAbility to learn how to utilize various types of electronic and/or manual \nrecording and information systems used by the agency, office, or related \nunits.\n\nAbility to read, write, speak, understand, and communicate in English \nsufficiently to perform the duties of this position. American Sign Language \nor Braille may also be considered as acceptable forms of communication.\n\nPersons with mental or physical disabilities are eligible if they can perform \nthe essential functions of the job with or without reasonable accommodation. \nIf the accommodation cannot be made because it would cause the employer \nundue hardship, such persons may not be eligible.\n\n<b>This job specification is applicable to the following title code:</b><b>Job<br />Spec<br />Code</b><b>Variant</b><b>State,<br />Local or<br />Common</b><b>Class of<br />Service</b><b>Work<br />Week</b><b>State<br />Class<br />Code</b><b>Local<br />Class<br />Code</b><b>Salary<br />Range</b><b>Note</b>01296SNNL28N/AP28-<br />This job specification is for <b>state</b> government use only.<br />Salary range is only applicable to state government.<br />Local salaries are established by individual local jurisdictions.<br /><br /> 7/30/2022","sections":{"DEFINITION":"Under the direction of a Medical Consultant, Chief Pharmaceutical Services or \nother supervisory official, as a licensed Pharmacist, is responsible for provision \nof pharmaceutical consultative services required to implement the pharmaceutical \nservices aspects of all department programs including Medicare, Medicaid, and \nPAAD programs; ensures pharmaceutical services provided by the department \nmeet all applicable regulatory and legal requirements as set forth by State and \nfederal agencies; does other related duties as required.","NOTE":"The examples of work for this title are for illustrative purposes only. \nA particular position using this title may not perform all duties listed in this \njob specification. Conversely, all duties performed on the job may not be \nlisted.","EXAMPLES_OF_WORK":"Provides professional pharmaceutical consultant services and oversight of \nthe pharmaceutical services aspect of the health services program in the \nregion or area designated by the department.\n\nDevelops appropriate provider communications through newsletters, alerts, \nand remittance advice messages, as they apply to the administration of \npolicies and procedures related to department pharmaceutical services.\n\nConfers with pharmacists and providers of medical supplies and equipment \nrelative to interpretation of the program.\n\nProvides consultation to staff and providers regarding medical supplies and \ndurable medical equipment.\n\nRefers items requiring prior approval, authorization, or review which cannot \nbe acted on locally due to possible conflict of interest to the district office \ndirector or designee to arrange for a final disposition.\n\nProvides consultation to professional and clerical staff assigned to assist with \nutilization review as auditing of pharmaceutical services furnished by eligible \nrecipients.\n\nIdentifies and maintains a roster of local medical-surgical supplies for use by \neligible recipients.\n\nReviews financial analyses performed by the contracted agent for the \nmaintenance of financial projections and rate setting for the NJ Medicaid \nprogram.\n\nEstablishes and maintains liaison and interprets the pharmaceutical services \naspect of the Medicaid program to staff of the Medicaid District Offices, staff \nof the County Welfare Boards or agencies, and staff of district offices of the \nDepartment of Children and Families; provides consultation and advice \naccordingly.\n\nEstablishes and maintains liaison and interprets the pharmaceutical services \naspect of the Medicare Part D program to staff of the County Offices on Aging; \nprovides consultation and advice accordingly. \n\nReviews Managed Care Organization (MCO) formulary updates and \npharmacy-related contractual issues regarding beneficiary access to \npharmaceutical benefits.\n\nAssists beneficiaries and pharmacy providers with the coordination of \nbenefits between Medicare Part D, Third Party Liability, Medicaid, and \nother state/federal programs; assesses Medicare Part D formulary \nlimitations to maximize coordination of benefits for beneficiaries.\n\nCollaborates in the development of State Plan Amendments and submits \nrequired annual reporting for the Centers for Medicare and Medicaid \nServices (CMS).\n\nConfers with pharmacists and peer review committees of local Pharmaceutical \nAssociations regarding all aspects of the pharmaceutical services program and \nparticipates in evaluating questionable practices, complaints of pharmacists \nand/or recipients, or unusual cases.\n\nOversees the NJ Drug Utilization Review Board (DURB), its protocols, and \nstandards for the State's claims processing system for pharmaceutical services.\n\nPerforms activities in accordance with department/division policies and \nprocedures to promote effective monitoring and control of appropriate utilization \nof pharmaceutical services; collaborates with the department, state auditors, and \nstate/federal fraud divisions to provide information and reports.\n\nParticipates with department/division staff in the further development, analysis, \nand evaluation of policies, procedures, and methods of providing pharmaceutical \nand health services to recipients; responds to legislative proposals containing \npharmaceutical-related issues for the State.\n\nContinuously reviews the quality and quantity of pharmaceutical services \nprovided to Medicaid recipients and others who receive department services by \nevaluation of printouts or profiles of recipients, pharmacists, and/or prescriptions \nto determine evidence of abuse, overuse, and/or appropriateness of services; \nconducts onsite inspections of prescriptions, invoice costs of pharmaceuticals, \nmedical supplies, and equipment to determine adherence to price or costing \nprovisions of the Health Services Program.\n\nRecommends to the pertinent department/division official suggested changes \nin policies and procedures based on local operational experiences.\n\nServes as subject matter expert (SME) for all state and federal pharmaceutical \nassistance programs, including but not limited to Medicare Part D, \nPharmaceutical Assistance to the Aged and Disabled (PADD), and Medicaid; \nserves as the state SME and liaison for the development, modification, and/or \nreplacement of management information systems for Medicaid, PADD, and \nother pharmaceutical programs.\n\nParticipates in training programs for staff members of the department/division \nconcerning the pharmaceutical services aspect of the Medicaid Program and \nother programs administered by the department and its agencies.\n\nParticipates in appeal hearings concerning pharmaceutical providers as well \nas recipients.\n\nWill be required to learn how to utilize various types of electronic and/or manual \nrecording and information systems used by the agency, office, or related units.","EDUCATION":"Graduation from an accredited college, university, or School of Pharmacy with \na Doctor of Pharmacy degree.","EXPERIENCE":"Four (4) years of experience as a Registered Pharmacist which shall have \nincluded two (2) years of experience with a large public health program, \nhealth carrier, hospital, and/or retail pharmacy.","LICENSE":"Possession of a valid license as a Registered Pharmacist issued by the \nState of New Jersey.\n\nAppointees will be required to possess a driver's license valid in New Jersey \nonly if the operation of a vehicle, rather than employee mobility, is necessary \nto perform the essential duties of the position.","KNOWLEDGE_AND_ABILITIES":"Knowledge of pharmaceutical practices and procedures.\n\nAbility to organize assigned work, analyze pharmaceutical and related \nproblems, and develop effective work methods.\n\nAbility to work as a member of a team designed to improve pharmaceutical \nservices provided to welfare recipients and the medically needy in the state.\n\nAbility to understand and interpret established pharmaceutical procedures \nin relation to specific cases.\n\nAbility to provide technical assistance to department staff.\n\nAbility to establish and maintain liaison between department facilities including \ndistrict offices and local Pharmaceutical Society or societies and the staff of \nCounty Welfare Boards or agencies.\n\nAbility to conduct conferences with peer review and other committees.\n\nAbility to effectively monitor and control appropriate utilization of \npharmaceutical and health services to recipients.\n\nAbility to conduct onsite inspections of prescriptions and medical supplies \nand equipment.\n\nAbility to make recommendations to pertinent department/division officials.\n\nAbility to participate in training programs for staff members.\n\nAbility to maintain essential records and files.\n\nAbility to learn how to utilize various types of electronic and/or manual \nrecording and information systems used by the agency, office, or related \nunits.\n\nAbility to read, write, speak, understand, and communicate in English \nsufficiently to perform the duties of this position. American Sign Language \nor Braille may also be considered as acceptable forms of communication.\n\nPersons with mental or physical disabilities are eligible if they can perform \nthe essential functions of the job with or without reasonable accommodation. \nIf the accommodation cannot be made because it would cause the employer \nundue hardship, such persons may not be eligible."},"searchable_text":"PHARMACEUTICAL CONSULTANT DEFINITION: Under the direction of a Medical Consultant, Chief Pharmaceutical Services or other supervisory official, as a licensed Pharmacist, is responsible for provision of pharmaceutical consultative services required to implement the pharmaceutical services aspects of all department programs including Medicare, Medicaid, and PAAD programs; ensures pharmaceutical services provided by the department meet all applicable regulatory and legal requirements as set forth by State and federal agencies; does other related duties as required. NOTE: The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed. EXAMPLES OF WORK: Provides professional pharmaceutical consultant services and oversight of the pharmaceutical services aspect of the health services program in the region or area designated by the department. Develops appropriate provider communications through newsletters, alerts, and remittance advice messages, as they apply to the administration of policies and procedures related to department pharmaceutical services. Confers with pharmacists and providers of medical supplies and equipment relative to interpretation of the program. Provides consultation to staff and providers regarding medical supplies and durable medical equipment. Refers items requiring prior approval, authorization, or review which cannot be acted on locally due to possible conflict of interest to the district office director or designee to arrange for a final disposition. Provides consultation to professional and clerical staff assigned to assist with utilization review as auditing of pharmaceutical services furnished by eligible recipients. Identifies and maintains a roster of local medical-surgical supplies for use by eligible recipients. Reviews financial analyses performed by the contracted agent for the maintenance of financial projections and rate setting for the NJ Medicaid program. Establishes and maintains liaison and interprets the pharmaceutical services aspect of the Medicaid program to staff of the Medicaid District Offices, staff of the County Welfare Boards or agencies, and staff of district offices of the Department of Children and Families; provides consultation and advice accordingly. Establishes and maintains liaison and interprets the pharmaceutical services aspect of the Medicare Part D program to staff of the County Offices on Aging; provides consultation and advice accordingly. Reviews Managed Care Organization (MCO) formulary updates and pharmacy-related contractual issues regarding beneficiary access to pharmaceutical benefits. Assists beneficiaries and pharmacy providers with the coordination of benefits between Medicare Part D, Third Party Liability, Medicaid, and other state/federal programs; assesses Medicare Part D formulary limitations to maximize coordination of benefits for beneficiaries. Collaborates in the development of State Plan Amendments and submits required annual reporting for the Centers for Medicare and Medicaid Services (CMS). Confers with pharmacists and peer review committees of local Pharmaceutical Associations regarding all aspects of the pharmaceutical services program and participates in evaluating questionable practices, complaints of pharmacists and/or recipients, or unusual cases. Oversees the NJ Drug Utilization Review Board (DURB), its protocols, and standards for the State's claims processing system for pharmaceutical services. Performs activities in accordance with department/division policies and procedures to promote effective monitoring and control of appropriate utilization of pharmaceutical services; collaborates with the department, state auditors, and state/federal fraud divisions to provide information and reports. Participates with department/division staff in the further development, analysis, and evaluation of policies, procedures, and methods of providing pharmaceutical and health services to recipients; responds to legislative proposals containing pharmaceutical-related issues for the State. Continuously reviews the quality and quantity of pharmaceutical services provided to Medicaid recipients and others who receive department services by evaluation of printouts or profiles of recipients, pharmacists, and/or prescriptions to determine evidence of abuse, overuse, and/or appropriateness of services; conducts onsite inspections of prescriptions, invoice costs of pharmaceuticals, medical supplies, and equipment to determine adherence to price or costing provisions of the Health Services Program. Recommends to the pertinent department/division official suggested changes in policies and procedures based on local operational experiences. Serves as subject matter expert (SME) for all state and federal pharmaceutical assistance programs, including but not limited to Medicare Part D, Pharmaceutical Assistance to the Aged and Disabled (PADD), and Medicaid; serves as the state SME and liaison for the development, modification, and/or replacement of management information systems for Medicaid, PADD, and other pharmaceutical programs. Participates in training programs for staff members of the department/division concerning the pharmaceutical services aspect of the Medicaid Program and other programs administered by the department and its agencies. Participates in appeal hearings concerning pharmaceutical providers as well as recipients. Will be required to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units. REQUIREMENTS: EDUCATION: Graduation from an accredited college, university, or School of Pharmacy with a Doctor of Pharmacy degree. EXPERIENCE: Four (4) years of experience as a Registered Pharmacist which shall have included two (2) years of experience with a large public health program, health carrier, hospital, and/or retail pharmacy. LICENSE: Possession of a valid license as a Registered Pharmacist issued by the State of New Jersey. Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position. KNOWLEDGE AND ABILITIES: Knowledge of pharmaceutical practices and procedures. Ability to organize assigned work, analyze pharmaceutical and related problems, and develop effective work methods. Ability to work as a member of a team designed to improve pharmaceutical services provided to welfare recipients and the medically needy in the state. Ability to understand and interpret established pharmaceutical procedures in relation to specific cases. Ability to provide technical assistance to department staff. Ability to establish and maintain liaison between department facilities including district offices and local Pharmaceutical Society or societies and the staff of County Welfare Boards or agencies. Ability to conduct conferences with peer review and other committees. Ability to effectively monitor and control appropriate utilization of pharmaceutical and health services to recipients. Ability to conduct onsite inspections of prescriptions and medical supplies and equipment. Ability to make recommendations to pertinent department/division officials. Ability to participate in training programs for staff members. Ability to maintain essential records and files. Ability to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units. Ability to read, write, speak, understand, and communicate in English sufficiently to perform the duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication. Persons with mental or physical disabilities are eligible if they can perform the essential functions of the job with or without reasonable accommodation. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible. This job specification is applicable to the following title code: Job Spec Code Variant State, Local or Common Class of Service Work Week State Class Code Local Class Code Salary Range Note 01296 S N NL 28 N/A P28 - This job specification is for state government use only. Salary range is only applicable to state government. Local salaries are established by individual local jurisdictions. 7/30/2022","snippet":"PHARMACEUTICAL CONSULTANT DEFINITION: Under the direction of a Medical Consultant, Chief Pharmaceutical Services or other supervisory official, as a licensed Pharmacist, is responsible for provision o...","salary_meta":{"range_number":28,"min_salary":88529.64,"max_salary":130338.5,"increment":4180.89,"schedule_year":2025},"education_level":"doctorate","experience_years":2,"has_license_requirement":true,"license_types":["driver","certification"],"pension_system":"PERS","revision_date":"2022-07-30","erg_prefix":"P","erg_schedule":"A-P-R-S","range_number":28,"erg_name":"Professional Unit","erg_union":"CWA","familyId":null,"familyName":null,"level":null,"specialization":null,"prefix":null,"isSupervisory":false}