Clinical Pharmacist - Clinical Consulting & Utilization Review (Hybrid)

Responsibilities

• Account-specific pharmacy utilization reviews
• Responding to account-specific clinical inquiries
• Developing clinical pharmacy recommendations
• Participating in pharmacy finalist presentations

Qualifications

• Education: Doctor of Pharmacy (PharmD)
• Licenses/Certifications: Required - PHARMD - Licensed Pharmacist No Direct Patient Care - Active Registered Pharmacist in any state and/or DC
• Experience: 5 years experience in clinical pharmacy, preferably in a managed care environment (PBM or health plan), or clinical consulting/sales environment. Preferred - Experience in account management/sales, Experience working in healthcare industry with a thorough understanding of prescription benefit management programs and practices.

Essential Functions

• Serve as the primary clinical subject matter expert supporting pharmacy account consultants in external client interactions, including utilization reviews, strategic discussions, and finalist presentations.
• Provide ongoing clinical consultation to external clients, brokers, and internal stakeholders on emerging pharmacy trends, therapeutic advancements, and formulary strategy.
• Acts as a clinical consultant for pharmacy account consultants and internal sales team with the goal of fostering strong partnerships that enhance client value and experience.
• Partner closely with pharmacy account consultants to provide a unified, consultative experience for clients, ensuring alignment between clinical pharmacy strategy and account priorities.
• Aid in the development and delivery of client-facing presentations that clearly communicate pharmacy utilization trends, market insights, clinical program performance, pharmacy strategy and strategic recommendations.
• Review and analyze account-specific pharmacy utilization, trend data and overall performance of formularies and/or utilization management to identify opportunities to improve clinical outcomes and cost efficiency.
• Evaluate the impact of clinical programs and recommend modifications based on performance insights and evolving standards of care.
• Work collaboratively with vendors, PBMs, accounts, and internal parties for oversight of clinical programs and performance management.
• Participate in the new pharmacy business process including but not limited to serving as a clinical pharmacy resource for review of written RFP responses and presenting at finalist meetings.
• Contribute clinical expertise to strategic discussions supporting new and existing business opportunities.
• Maintain awareness of pharmacy market developments, including new drug approvals, pipeline trends, and competitor strategies and translate these market insights into practical recommendations that help inform client strategy and decision-making.