The Drug Utilisation Pharmacist manages the financial and clinical risk of contracted medical schemes by implementing the policies, protocols and formularies for reimbursement for medicines. The DUR pharmacist will implement Medicine and Oncology Management through the performance of Treatment Reviews and intervene with providers for cost effective therapies where appropriate.
Duties and responsibilities
- Review applications for medicine and oncology benefits of a medical scheme for eligibility for the specific medicine and oncology benefit.
- The DUR pharmacist must assess whether the diagnosis is eligible for re-imbursement according to the Scheme’s rules.
- All necessary supportive documentation must be obtained by the DUR pharmacist in support of the request.
- Assess each application for medicine and oncology benefits according to the Scheme rules and available benefits.
- Perform a drug utilisation review on the application. This entails an assessment of all the medicines prescribed for a patient with respect to appropriateness for the medical condition (according to the most recent therapeutic guidelines for the condition), dosage, safety, side effects, duration of therapy and affordability.
- Identify more appropriate and/or more affordable medicines per patient.
- Recommend to the patient’s doctor all potential changes to the prescribed medicines. Suggest alternatives to the doctor. Be able to substantiate recommended changes if requested.
- All DUR must be performed in accordance the DUR policies and protocols developed and maintained by Universal Care.
- Authorise the approved medicines per patient using the Medicine and Oncology Management software.
- Communicate with prescribers, dispensing pharmacists and patients as necessary.
- Provide advice or information as required by Customer service personnel with regards to answering queries about medicine authorisations.
- Maintain knowledge of medicines and keep abreast with changes in treatment guidelines and with pharmaceutical products available in South Africa.
- Assist in developing and maintaining formularies for medicines and oncology
- Research, prepare and present out-of-protocol requests at Clinical meetings
- Research and prepare clinical summaries for ex-gratia requests
- Research and prepare information on medicines newly registered in South Africa for drafting of protocols
- Maintain records of work performed.
- These duties may change from time to time in response to the changing needs and circumstances associated with medicine management in the medical scheme environment.
Required profile for job ad : Oncology DUR Pharmacist - Windhoek
Experience and qualifications
- B. Pharm degree.
- Registered with Pharmacy Council of Namibia.
- Experience in DUR or medical scheme environment an advantage.
- Experience and knowledge of Oncology and other Chronic diseases an added advantage.
- Experience and knowledge of the medical scheme environment an advantage.
- Experience and knowledge of the medical schemes legislation particularly pertaining to PMBs an advantage.
Key Competencies and Skills
- Excellent communication skills
- Interpersonal and customer service focus
- Sound problem solving skills
- Compassion and empathy
- Ability to multitask
- Attention to detail
Language requirements
- Highly proficient in English. Be able to speak, write, spell, read and comprehend the language.
- Other languages: The ability to converse in another local language e.g. An African language or Afrikaans an advantage.
- All written and verbal communication must be conducted in a professional manner.
- Strong verbal and written communications skills.
Computer literacy
- Proficiency with the following programmes is required:
- MS Word
- MS Excel
- MS Outlook / email
- MS Explorer / Internet
- PowerPoint
Work Requirements
- The company is based in Namibia, Windhoek.
- Own reliable transport
- The hours of work: Office hours from Mon to Fri, 8am to 5pm.
- Willingness to work longer hours when the business needs require the DUR pharmacist to do so is a requirement.
- Confidentiality of all patients’ clinical information and conditions to be maintained and respected. The employee may be required to sign a confidentiality agreement.
- Company intellectual property and systems may not be disclosed to external agent or organization.
Remuneration
- A competitive salary and benefits will be negotiated, consistent with experience and the role and responsibilities of the position.
