Senior Clinical Pharmacist

🔥 12 hours ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $107.7k - $199.3k / year

⏰ Full Time

🟠 Senior

💊 Pharmacist

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Define and develop standard and custom formularies for complex or specialized medications • Develop clinical criteria for medication reviews and recommend plan design changes • Monitor and review prior authorization and appeal requests • Develop clinical edits to adjudicate claims and enhance drug utilization • Analyze pharmacy cost of care and utilization trends • Coordinate protocols, guidelines, client reports, and regulatory reporting • Develop and implement medication therapy management programs • Evaluate program performance and implement improvements • Ensure quality controls and identify performance improvement opportunities • Research drug information for prior authorization reviews • Provide clinical guidance to departments and address clinical questions • Support evaluation, development, and expansion of clinical pharmacy programs • Analyze pharmacy data and trends to improve member outcomes • Develop strategic relationships supporting organizational initiatives • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy • 4+ years of mail order, retail, hospital, managed care pharmacy experience or pharmacy residency program experience • Current state’s Pharmacist license with no restrictions • May be required to obtain additional state licensure based on business needs • Knowledge of drug information and disease states • Ability to support clinical program outcome analysis and evaluation across patient populations • Ability to develop and analyze clinical programs across Commercial, Medicaid, Medicare Part D and the Health Insurance Marketplace • Compliance with all policies and standards

🏖️ Benefits

• Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity

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