Clinical Pharmacy Consultant

About the role

This role is available in Atlanta, Chicago, Denver, Houston, Los Angeles, Phoenix, Portland & San Francisco, offering a hybrid work arrangement with a minimum of three days per week in the office.

Responsibilities

• Act as the specialty pharmacy resource for your assigned clinical team(s) to assist in the identification and management of potential and actual high cost claimants.
• Interpret pharmacy data reporting shared by the benefit administrators and leverage this information for selection of HCC cases for review.
• Participate in discussions with the benefit administrators’ clinical teams to identify strengths and opportunities in how the case is being managed and offer suggestions to shape the course of the member’s care moving forward.
• Create summary reports to Mercer H&B teams, coalition partners and/or clients in a clear and constructive manner.
• Participate in Pharmacy Practice meetings and ensure Mercer's point of view on effective pharmacy clinical management strategies is effectively communicated.
• Incorporate compliance and professional standards into all work processes, including transparency, peer review and maintaining required licensure.
• Maintain effective carrier/vendor relationships to represent Mercer and to serve our clients.
• Provide mentoring and coaching to team members on specialty medications and pharmacy management.
• Aid in the development of ongoing training presentations and other learning collateral used to influence care outcomes.
• Support wellness consulting projects by providing pharmacy subject matter expertise to cross-functional teams working in areas such as chronic conditions management, ensuring pharmacy insights meaningfully shape clinical and financial outcomes for our clients.
• Conduct pharmacy assessments to support Mercer’s clinical care management model across various managed care organizations.
• Aid with other consulting projects as needed.

Requirements

• Active, unencumbered Pharmacy license.
• At least 7+ years relevant work experience in clinical pharmacy.
• Ability to navigate MS Office Tools (Word, Excel, PowerPoint, Teams).
• Clinical acumen to evaluate specialty medication regimens, make evidence-based recommendations and suggestions to shape the course of the member’s care moving forward.
• Prioritization and handling of multiple tasks in a demanding work environment.
• Strong communication skills with ability to share highly technical information in a non-technical fashion; strong business writing skills.
• Ability to partner and lead teams to produce client deliverables.
• Ability to work independently and on a team.

Qualifications

• Pharm.D. degree from an accredited college of pharmacy.
• Certified Specialty Pharmacy (CPS) with the National Association of Specialty Pharmacy.
• Experience supporting infused specialty medications.
• Experience in managed care settings.
• Experience conducting prior authorization reviews.
• Clinical payer (carrier) experience, including demonstrated clinical leadership.

Skills

• Thrive and be motivated by an environment that embraces AI and technology-enabled tools.

Benefits

We offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.