Clinical Pharmacist - Utilization Management Archimedes

Archimedes is the industry leader in specialty drug management solutions, transforming the PBM industry to provide alignment, value, and transparency. We eliminate conflicts of interest such as drug spread, rebate retention, and pharmacy ownership, delivering rigorous clinical management at the lowest net cost for health plans and employer groups.

About the role

We are seeking a clinical professional with specialty drug management experience and a passion for cost management. This role will focus on external clinical outreach activities, including high-cost case management and prior authorization of specialty medications across pharmacy and medical benefits. Additionally, the role involves evaluating data to identify actionable opportunities for specialty management and creating clinical policies. The Clinical Pharmacist will serve as the clinical expert for all specialty medications, communicating with physicians, nurses, pharmacists, and members on high-cost case concerns, dose management, genetic testing, therapeutic substitutions, and cost management. This position can be located in our Brentwood, TN or St. Louis, MO offices or considered for remote employment.

Responsibilities

• Develop and deliver clinical messages to physicians, members, clients, and consultants
• Manage prior authorization, high-cost cases, claims editing, and clinical policy development
• Clinical program development including both medical and pharmacy benefit management
• Define, document, and deliver results for plan sponsors
• Evaluate and summarize clinical literature as well as financial implications related to medication management options
• Present deep clinical and cost-effectiveness information as a peer-to-peer consult

Requirements

• Doctor of Pharmacy (PharmD)
• Current pharmacist license (RPh) in good standing with a State Board of Pharmacy
• Board of Pharmacy Certification preferred (Pharmacotherapy, Ambulatory Care, or Oncology Care)
• 3 years of clinical or managed care experience or Clinical/Managed Care Pharmacy Residency preferred
• Pharmacy and medical specialty benefit knowledge and experience

Skills

• Independent, proactive, forward-thinking, and creative problem solver
• Results-oriented with the ability to work well in a team environment
• Strong verbal and written communication skills
• Strong physician-facing clinical communication skills
• Proficiency in Microsoft Excel, PowerPoint, and Word

Schedule

Monday–Friday, 8:00 AM to 5:00 PM (Hybrid in-office: 3 days)