Clinical Pharmacist – Pulse PBM

🔥 12 hours ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $125k - $130k / year

⏰ Full Time

🟢 Junior

💊 Pharmacist

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Revive

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2020

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Venture Round - ReviveHealth on 2023-01

Healthcare • Consulting • Logistics

Revive is a virtual healthcare company (ReviveHealth) that provides an integrated whole-person virtual care platform for employers and members. It combines 24/7 virtual urgent care, longitudinal virtual primary care, mental health/EAP, integrated pharmacy services (including $0 generics, home delivery, and specialty drug sourcing), and a physician-supervised weight-health program into a subscription-based solution designed to complement existing insurance. Revive focuses on enterprise (employer) customers, rapid deployment, high member engagement, and cost containment for plan sponsors.

📋 Description

• Serve as the clinical lead on new client implementations and guide plan sponsors and brokers through benefit design decisions • Translate client benefit design decisions into clinical edits, prior authorization criteria, step therapy, and quantity limits • Analyze prior-PBM claims and formulary data and recommend transition-of-care strategies • Monitor pharmacy claims in real time for high-cost claims, inappropriate utilization, safety concerns, and savings opportunities • Recommend therapeutic interchanges, generic and biosimilar alternatives, and lower-net-cost options • Coordinate with prescribers and members to implement therapy changes • Analyze clinical reviews for prior authorizations, formulary exceptions, and coverage determinations • Conduct prospective, concurrent, and retrospective drug utilization review • Manage and execute cost-containment programs, including international pharmacy, 340B, and manufacturer patient assistance programs • Generate clinical and financial reports covering utilization trends, cost drivers, specialty spend, program savings, and clinical outcomes • Prepare clinical content for and participate in quarterly business reviews • Serve as a clinical point of contact for plan sponsors, brokers, TPAs, and members • Communicate with members and prescribers about therapy changes, program enrollment, and coverage decisions • Draft member and client communications • Collaborate with pharmacy executives, account management, operations, and claims processing teams • Advise on new drug approvals, pipeline developments, guideline changes, biosimilar launches, and patent expirations • Maintain documentation and ensure compliance with HIPAA, ERISA, ACA, state pharmacy regulations, and internal policies

🎯 Requirements

• Doctor of Pharmacy (PharmD) from an ACPE-accredited college of pharmacy • Active, unrestricted pharmacist license in good standing, with the ability to obtain additional state licenses as required • Minimum of 1 year of pharmacist experience in a PBM, managed care, health plan, or clinical pharmacy setting • Working knowledge of formulary management, utilization management, prior authorization criteria, and specialty pharmacy • Understanding of PBM economics, including net cost, rebates, pricing, and pass-through models • Knowledge of cost containment programs such as copay maximizer, 340B, and patient assistance programs • Strong analytical skills, including working with claims data and advanced Excel • Excellent written and verbal communication skills, with the ability to present to clients, brokers, and executives • Attention to detail and ability to manage multiple clients, deadlines, and priorities in a fast-paced environment

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