Clinical Pharmacist - Specialty Drug Utilization Management (Hybrid)

Responsibilities

• Develops and executes on strategies to manage pharmacy and medical benefit drug spend with a focus on specialty drugs.
• Tracks productivity, quality, impact, and overall performance of utilization management strategies.
• Identifies areas where program modifications could result in improvements to patient outcomes and reduce costs.
• Works collaboratively with vendors, PBMs, and internal parties for oversight of programs and performance management.
• Acts as a specialty drug subject matter expert; provides expertise to both internal and external stakeholders regarding specific pharmacy trends and market insights; provides recommendations to control specialty drug costs across pharmacy and medical benefits.
• Develops and provides formal written and verbal presentations or other communication materials related to specialty drug management, pharmacy utilization, pharmacy strategy, and pharmacy topics to a broad audience including both internal and external stakeholders.
• Affirms value of specialty drug management strategies through clinical outcomes, usage, quality, and financial metrics to assist in meeting strategic plan goals.
• Ensures pharmacy programs are compliant with regulatory mandates.
• Reviews pharmacy market information and trends to develop and coordinate implementation of appropriate strategies or programs for cost containment and clinical management with a focus on specialty drugs.

Qualifications

• Education Level: Ph.D., Pharmacy (Doctorate of Pharmacy).
• Licenses/Certifications Upon Hire Required: PHARMD - Licensed Pharmacist Direct Patient Care - Active Registered Pharmacist in Maryland and/or DC or 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.
• PREFERRED QUALIFICATIONS: Experience in Medicare and/or Medicaid, Experience working in healthcare industry with a thorough understanding of prescription benefit management programs and practices across multiple lines of business (Commercial, Medicare, Medicaid), with a focus on specialty pharmacy. Certified Specialty Pharmacist (CSP) credential preferred.