Clinical Pharmacist – Cost Containment

🔥 0 minutes ago

☕ Washington – Remote

☕ Washington – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 10%

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.

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TrueScripts Management Services

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2014

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

TrueScripts Management Services is dedicated to providing exceptional prescription benefit management services. With a focus on delivering maximum savings and amazing care, TrueScripts works closely with members, clients, brokers, and prescribers to offer personalized and customized solutions. The company prides itself on transparency and efficiency, featuring a 24-48 hour turnaround time for prior authorization requests and a commitment to customer service, ensuring that real people are available to assist over 99% of the time.

📋 Description

• Provide clinical pharmacy expertise to support development, implementation, and ongoing management of cost containment programs • Evaluate prescription drug utilization, prescribing patterns, formulary opportunities, and emerging therapies to identify cost savings • Design and refine programs promoting clinically appropriate, cost-effective medication utilization • Evaluate new program opportunities for clinical appropriateness, operational feasibility, financial impact, and member implications • Evaluate medication disruption and transition opportunities for new business members • Review physician and member inquiries and appeals related to clinical appropriateness of drug or pharmacy alternatives • Provide ongoing clinical support for assigned programs, including setup, implementation, maintenance, and continuous improvement • Develop and maintain clinical criteria, workflows, documentation, and operational guidance • Resolve complex clinical questions, exceptions, and escalations • Identify workflow gaps, reduce manual processes, and improve program efficiency • Monitor program performance and identify opportunities to improve effectiveness, consistency, and scalability • Analyze drug utilization, claims trends, prescribing patterns, and related data • Evaluate program performance and validate savings opportunities with Analytics, Finance, and stakeholders • Develop program metrics, reporting, and performance dashboards • Review results, identify trends and unexpected outcomes, and recommend adjustments • Document program value and communicate clinical and financial results to stakeholders and clients • Partner cross-functionally with Pharmacy Networks, Client Services, Implementation, Compliance, and other departments • Provide clinical education and guidance to internal team members • Participate in client discussions, program reviews, and internal strategy sessions • Support standardized processes, resources, and training materials • Support compliance with federal and state requirements, contractual obligations, clinical standards, and internal policies • Maintain documentation of clinical decisions, program criteria, and changes • Identify risks, quality concerns, and process gaps and escalate them • Stay current on pharmaceutical trends, emerging therapies, drug pricing, and industry practices • Recommend process improvements supporting program quality and scalable growth

🎯 Requirements

• Doctor of Pharmacy (Pharm.D.) degree from an accredited college of pharmacy • Active pharmacist license in good standing in the state of residence, with the ability to obtain additional licensure as required by the position • Strong clinical knowledge of pharmacotherapy, medication utilization, formulary management, and evidence-based prescribing • Demonstrated analytical, problem-solving, and critical-thinking skills • Ability to interpret clinical information and translate findings into practical recommendations • Strong written and verbal communication skills • Ability to collaborate effectively across departments and with stakeholders at varying levels of the organization • Strong organizational skills and ability to manage multiple priorities in a growing, fast-paced environment • Experience working in a pharmacy, PBM, healthcare, or clinical environment preferred • Familiarity with formulary management or pharmacy benefit operations preferred • Experience supporting clinical programs or healthcare initiatives preferred • Experience with spreadsheets, reporting tools, workflow systems, or project-management tools preferred • Familiarity with pharmacy terminology and clinical program concepts preferred • Experience documenting processes and developing standard operating procedures preferred • SQL experience is a plus

🏖️ Benefits

• A wide range of health insurance options including medical, dental and vision • A strong salary and bonus program • A robust 401k and company match • ESOP shares allocated each year through a qualified retirement plan • Employee Assistance Program • Wellness program including financial incentives, chiropractic and massage services, and fitness stipends • Dream Manager Program • Cohesive, family-based culture • Charitable contributions and volunteer time