Clinical Pharmacist Formulary Management

View full description

Requirements:

• 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.)

Responsibilities:

• 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%