Health Plan Clinical Pharmacist

Job not on LinkedIn

🔥 0 minutes ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $138k - $170.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Martin's Point Health Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🛡️ Insurance

📦 Logistics

💼 Consulting

Insurance • Logistics • Consulting

Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

📋 Description

• Develop and implement clinical pharmacy strategies for high-quality, cost-effective pharmacy management and outcomes • Identify and develop evidence-based pharmaceutical utilization cost-savings programs and initiatives • Monitor and support pharmacy-related quality measures, including Medicare Star Ratings and HEDIS • Collaborate with quality and population health teams to identify medication-related gaps in care and support interventions • Serve as a drug information expert for the mail order pharmacy, health plan team members, and affiliated practices • Support development and maintenance of the Health Plan Drug Formulary • Coordinate and participate in drug prior authorizations and other pharmacy utilization management activities • Develop and disseminate educational materials, newsletters, and member/provider talking points • Pursue professional development and identify industry trends, best practices, and innovative solutions • Assist staff with drug information, clinical initiatives, benefit design and interpretation, claims processing issues, and marketing support • Ensure pharmacy and PBM systems reflect accurate benefit and drug coverage • Assist in resolving claims adjudication problems requiring clinical expertise • Participate in activities ensuring compliance with Department of Defense and Medicare Part D regulations • Develop and revise policies, procedures, and protocols as needed • Demonstrate the organization’s mission, vision, and core values

🎯 Requirements

• Pharm.D. or BS in Pharmacy with relevant clinical experience • Current license/eligible for licensure to practice pharmacy in ME; license must be unrestricted to perform UM functions • 3+ years of retail, hospital, or managed care pharmacy experience • Extensive knowledge of drug products, medical therapeutics, pharmacokinetics, and disease states • Knowledge of PBM third-party billing, pharmacy claims processing, and pharmacy data management • Excellent customer service skills • Superior written and verbal communication skills • Proficiency in Microsoft Office applications (Word, Excel, PowerPoint) • Strong organizational skills and ability to prioritize and multitask • Strong interpersonal skills and ability to collaborate with internal and external clients • Strong mathematical ability • Thorough clinical knowledge of therapeutic drug utilization • Ability to function independently with sound judgment in decision-making • Ability to take appropriate initiative while soliciting input/advice appropriately • Ability to handle confidential and sensitive information discreetly and professionally • Demonstrated ability to review and analyze data • Must not require immigration sponsorship

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Retirement savings with employer contributions • Paid time off • Volunteer time off • Pie day • Other employee benefits • Potential eligibility for incentive or commission-based programs, where applicable and subject to plan terms