Clinical Formulary Management Pharmacist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $108k - $184k / year

⏰ Full Time

🟢 Junior

💊 Pharmacist

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Prime Therapeutics

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1998

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Prime Therapeutics is a trusted pharmacy solutions provider dedicated to transforming health care through innovation and transparency. The company offers a wide range of services including clinical solutions for improved member outcomes, drug access and affordability, specialty drug management, and condition management for chronic health issues. With over 7,000 employees, Prime Therapeutics aims to challenge norms in the pharmacy industry, providing exceptional experiences and simplifying the complex for millions across the nation. Their mission goes beyond profit, focusing on creating transformative impacts with long-term solutions, utilizing modern technology and holistic approaches in specialty pharmacy management. Owned by mission-driven partners, Prime Therapeutics emphasizes true transparency and conflict-free service, fostering a culture of care and shared purpose in health care.

📋 Description

• Manage formularies and clinical criteria for claims adjudication, prescription drug lists, websites, and related publications • Participate in clinical and financial drug review committees • Perform drug and drug-class reviews and develop formulary placement and utilization management recommendations • Research and explain clinical and business considerations related to drugs, drug classes, and formulary strategies • Provide subject matter expertise to resolve formulary issues • Monitor weekly drug files for new products and apply appropriate drug statuses and formulary placement • Perform routine formulary quality reviews using reports and pharmacy data to identify and resolve discrepancies • Develop and coordinate communications for members, clients, prescribers, pharmacies, and internal stakeholders regarding formulary changes • Serve as liaison among clinical, operational, technical, client, and publishing teams • Maintain committee documentation and action items • Develop team procedures, checklists, and operational best practices • Perform other duties as assigned

🎯 Requirements

• PharmD or Bachelor of Science Pharmacy degree • 1 year of pharmacy experience in a retail, mail order, health plan, PBM, or similar setting as a pharmacist • Current Pharmacist license to practice in the applicable state(s) • Must be eligible to work in the United States without the need for work visa or residency sponsorship • Knowledge of prescription drugs, disease states, therapeutic classes, formulary management techniques, prescription benefit designs, and current healthcare industry trends • Strong project management, prioritization, and organizational skills • Ability to meet short turnaround times and manage deadline-driven work with minimal oversight • Excellent written and verbal communication skills • Strong analytical and problem-solving skills with attention to detail and quality • Ability to work collaboratively across teams while independently managing day-to-day responsibilities • Ability to quickly learn computer systems and software • Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint • Experience with health plan, PBM, Managed Medicaid, formulary operations, drug review committees, or utilization management (preferred) • Experience with formulary adjudication, clinical criteria implementation, prescription drug list publishing, or pharmacy data analysis (preferred) • Experience with Microsoft Visio or Access (preferred) • Must understand, comply with, and attest to job-specific security responsibilities and controls • Must comply with applicable legal, regulatory, contractual requirements, and internal policies and procedures

🏖️ Benefits

• Benefits, incentives and additional compensation (details available on the Benefits Page) • Equal opportunity and affirmative action employer • Reasonable accommodations for qualified applicants with disabilities • Tobacco-Free Workplace

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