Apply🔍 Pharmacy Benefit Management
- Registered pharmacist, RPh or PharmD required
- Active and unrestricted Pharmacist license
- 3-5 years of managed care or PBM experience, preferred
- Formulary management experience, preferred
- Residency/fellowship completion, preferred
- Ability to manage multiple projects at a time, required
- Analytical thinking and strong problem solving abilities
- Knowledge of pharmacy benefit design, drug utilization management, and healthcare regulations
- Strong attention to detail and accuracy in data management
- Effective communication and presentation skills to interact with cross-functional teams and clients
- Proven time management, organizational, and multi-taking skills
- Ability to work independently and collaboratively within a team
- Proven commitment to high quality work
- Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, etc.)
- Remain current with industry trends and provide clinical intelligence to internal teams and clients
- Monitor drug pipeline and assess new drugs to the market to determine appropriate formulary management strategies
- Develop and present clinical material at Pharmacy and Therapeutics Committee meetings, ensuring clarity and relevance
- Work closely with upstream and downstream partners on formulary decisions and updates
- Analyze large data sets to identify utilization trends/outliers and implement appropriate utilization management edits
- Investigate/resolve clinical issues and escalate issues to management as required
- Collaborate with internal and external teams to support client inquiries and provide insight on drug spend, utilization, clinical alternatives, and formulary compliance
- Assist in responding to clinical RFI and RFP questions
- Communicate formulary changes, formulary status, and clinical benefit coverage to internal and external teams
- Provide oversight of client specific formulary marketing materials
- Work with analysts to oversee clinical edit/drug list development and ensure appropriateness of formulary and clinical benefit adjudication in claims processing system
- Participate in implementation meetings and provide clinical and operational support for the transition of new clients over to AffirmedRx standard or custom formularies.
- Develop formulary management programs and cost savings initiatives
- Ensure formulary is compliant with regulatory requirements
- Develop and maintain department process documents
- Travel up to 10%
Posted about 1 month ago
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