Remote Clinical Pharmacist | WFH

Job Overview

As a Clinical Pharmacist, you will be pivotal in advancing clinical strategies that enhance the effectiveness of medical and pharmacy drug programs. You will serve as a crucial resource for drug information, working collaboratively with the Health and Pharmacy Services team, the Pharmacy and Therapeutics (P&T) Committee, and various internal stakeholders. Your primary responsibilities will involve the development and ongoing maintenance of evidence-based policies, management of clinical drug programs, and active participation in P&T Committee initiatives, all aimed at improving care quality and achieving cost-effective outcomes for our members.

Initially, your focus will be on conducting thorough clinical reviews of medication appeal requests. As you progress in this role, you will have opportunities to further engage in formulary development and provide significant support to the P&T Committee.

Key Responsibilities

• Develop and implement clinical pharmacy programs to promote quality and cost-effective drug prescribing.
• Support medical management and clinical pharmacy initiatives through the research and management of drug utilization programs, including Drug Utilization Reviews (DURs) and formulary management.
• Prepare and deliver therapeutic class reviews and drug monographs for presentation to the P&T Committee.
• Research and synthesize in-depth clinical data regarding drug therapies to create evidence-based programs for both pharmacy and medical benefits.
• Identify and recommend interventions to optimize medication regimens, reduce costs, and enhance quality outcomes.
• Lead internal pharmacy management projects and assist with initiatives involving contracted pharmacy benefit managers.
• Conduct clinical evaluations of medication appeal requests, applying clinical judgment to make informed coverage determinations.
• Serve as a clinical resource for healthcare professionals, providing expertise on drug-related inquiries, including DURs and therapeutic interventions.
• Collaborate with the Marketing and Communications team to prepare and distribute information to network providers.
• Ensure compliance with all regulatory and accreditation standards pertaining to pharmaceutical practices.
  
  

Required Skills

• Diverse experience in clinical pharmacy.
• Strong analytical and critical thinking capabilities.
• Exceptional communication and presentation skills, with the ability to convey complex information clearly.
• Proficiency in Microsoft Office, particularly with intermediate Excel skills (e.g., pivot tables, trend analysis, formulas).
• Strong consulting and interpersonal abilities, enabling effective collaboration with clinical peers and stakeholders.
• Self-motivated with the ability to work independently and as part of a cross-functional team.
  
  

Qualifications

• Bachelor's Degree in Pharmacy or PharmD.
• Active and unrestricted Pharmacy license in Iowa or South Dakota (must obtain licensure in the state of residence within six months of hire).
• Minimum of 3 years of managed care pharmacy experience or completion of a pharmacy residency program.
• Comprehensive understanding of the healthcare delivery system, managed care, and pharmacy benefit management.
  
  

Career Growth Opportunities

This position provides a robust platform for professional development, with exposure to diverse clinical programs and initiatives. There will be opportunities for mentorship and active participation in drug management strategies that can significantly enhance your career trajectory within managed care pharmacy.

Company Culture And Values

Our organization values collaboration, innovation, and a commitment to improving healthcare outcomes for our members. We foster an inclusive environment where teamwork and evidence-based decision-making are paramount to our success.

This role requires signing a non-compete agreement. We are an equal opportunity employer, dedicated to cultivating a diverse and inclusive workforce. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity, or any other protected characteristic.

Employment Type: Full-Time