Clinical Pharmacist

About the role

Act as an expert on clinical pharmacy issues. Provide support to pharmacy program management and assist in the development and maintenance of cost-effective pharmacy programs. Respond to internal questions concerning plan coverage and policies for specific pharmaceuticals and research appropriateness of drug therapies.

Responsibilities

• Act as an expert on clinical pharmacy issues within the organization and to external companies including the company Pharmacy Benefit Manager.
• Respond to clinical questions regarding prescription medications including those utilized by members.
• Ensure that prescribed medications and other pharmaceutical services are prescribed and dispensed according to plan pharmacy benefit designs and policies, professional standards, and state and federal requirements.
• Assist in the development and maintenance of cost effective pharmacy programs.
• Provide insight to pharmacy management services related to disease management initiatives.
• Collaborate with internal departments and physicians to improve prescription and clinical practices to ensure high quality, cost-effective care.
• Review prescriptions issued by physician or other authorized prescriber to ensure appropriateness of therapy and compliance with the formulary.
• Assist in the development of physician educational interventions.
• Analyze prescription data, identify areas for improvement, and provide recommendations to physicians.
• Educate internal departments on plan policies, benefits, and any other administrative matters related to pharmacy.
• Perform other duties as assigned.

Requirements

• Bachelor’s degree in related field
• Valid Pharmacist license in the state of Rhode Island

Qualifications

• Experience with Medication Therapy Management and Medicare Stars program
• Knowledge of formularies, rebate contracts, and pharmacy benefit design
• Knowledge of cost containment and utilization review strategies
• Knowledge of state and federal laws as applicable to the health insurance industry
• Knowledge of health care plans and benefits
• Analytical skills
• Strong communication and presentation skills
• Interpersonal skills

Skills

• Three to five years experience in managed care
• Pharmacy management experience
• Specific knowledge and training in prescription drugs, pharmacy benefits, utilization review, cost containment strategies, and emerging technology

Benefits

• Flexible work arrangements that include remote and hybrid opportunities
• Paid time off
• Tuition reimbursement
• Assistance with student-loan repayment
• Health, dental, and vision insurance
• Programs that support mental health and well-being
• Bonuses and investment plans
• Additional paid time to volunteer

Pay

$116,900.00 – $187,100.00

Schedule

• In-office: onsite 5 days per week
• Hybrid: onsite 2–4 days per week
• Remote: onsite 0–1 days per week

Permitted to reside in: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia (pending approval from the Human Resources Department)