Pharmacist

Location: Candidates must reside in the state of Wisconsin. This position is eligible for a hybrid workplace model, combining remote work from a home office (reliable internet required) with on-site work at our Brookfield or Menasha offices.

About the role

The Pharmacist provides clinical support for pharmacy, quality, compliance, and health management efforts. Responsibilities include Case Management, Disease Management, Medication Therapy Management, Drug Utilization Review, and developing Clinical Programs to improve outcomes and cost-effective drug therapy. The role involves assisting in the development and evaluation of the plan formulary and benefit designs, reporting to the NHP P&T Committee, and collaborating with other departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. The Pharmacist also supports provider education and detailing outreach efforts.

Responsibilities

• Assist with Commercial compliance workplan oversight.
• Follow up with PBM regarding claim audits (benefit change forms, member reimbursement/recoupments, and follow-up audits to monitor effectuation of changes).
• Participate in case management, disease management, and poly-pharmacy for NHP patients with extraordinarily high drug costs, including related services.
• Provide physician education, such as creating articles for the pharmacy newsletter, speaking to medical departments about drug issues, and addressing individual provider concerns for NHP members.
• Assist with Concurrent DUR, Retrospective DUR, and MTM programs.
• Support formulary management and identify Utilization Management (UM) criteria.
• Perform other duties and responsibilities as assigned.

Requirements

• Current Pharmacist licensure without restriction by the State of Wisconsin Pharmacy Examining Board.
• Bachelor of Science in Pharmacy required; Doctor of Pharmacy preferred.
• Minimum of 3 years of clinical experience.
• Residency/fellowship preferred.
• Managed care experience desirable.

Qualifications

Preferred experience in at least one of the following areas:

• Medication Therapy Management Programs
• Long Term Care Pharmacy consulting
• Decentralized hospital pharmacy services

Schedule

1.0 FTE, 40 hours per week, 8:00 AM – 5:00 PM, Monday through Friday.

Benefits

Opportunities to volunteer in your local community as part of paid employee initiatives.