Associate Clinical Pharmacist – Pharmacy Analytics

Wellmark, Inc.•Des Moines, IA

2d•Hybrid

About The Position

The Associate Clinical Pharmacist combines pharmacy expertise with analytical and problem-solving skills to evaluate pharmacy opportunities focused on quality improvement, affordability, and member outcomes. The role assists with developing formularies and evidence-based prior authorization criteria, conducting drug utilization analyses, evaluating digital health solutions and vendor offerings, and creating tools to track clinical and financial outcomes and the value of pharmacy interventions. The position supports evidence-based decision-making and works with Business Analytics, Actuarial, and Health Services teams to assess opportunities and demonstrate their impact. The role assists in developing and implementing pharmacy programs that promote quality and cost-effective drug use, provides clinical consulting and education, and supports drug utilization and formulary management. It researches and synthesizes clinical data, prepares therapeutic class reviews and drug monographs for the Pharmacy and Therapeutics Committee, supports prior authorization criteria development, and reviews escalated authorization requests for medical necessity and coverage. The pharmacist coordinates drug therapy interventions intended to improve quality and outcomes and reduce costs, collaborates with pharmacists, technicians, physicians, and other stakeholders, and supports internal and pharmacy benefit manager projects. The position also serves as a clinical resource, supports utilization reviews and therapeutic interventions, processes non-formulary prior authorization reviews, and complies with applicable regulatory, accreditation, and internal standards. This is a hybrid position based in Wellmark's Des Moines office, with at least three days onsite (Tuesday through Thursday) and the option to work remotely Monday and Friday. A non-compete agreement is required.

Requirements

Bachelor's degree in Pharmacy or PharmD.
Active, unrestricted pharmacy license in Iowa or South Dakota, with licensure in the state of residence required within six months of hire.
At least two years of foundational experience in retail pharmacy operations; internships may count.
Demonstrated experience making evidence-based decisions.
Effective analytical, problem-solving, and critical-thinking skills.
Strong written and verbal communication skills, including the ability to accurately summarize clinical literature.
Strong interpersonal skills and the ability to build rapport, credibility, and collaborative partnerships with clinical peers, leaders, and stakeholders.
Proficiency in Microsoft Office and intermediate Excel skills, such as pivot tables, trend analysis, and formulas.
Ability to apply relevant rules, regulations, and guidelines and maintain awareness of their implications for pharmacy.
Effective organization and prioritization skills, including the ability to manage multiple projects and meet deadlines.
Ability to work independently and collaboratively as a member of a cross-functional team.
Must not require immigration sponsorship or additional work authorization now or in the future to work in the United States.

Nice To Haves

Diverse pharmacy work experience, including non-retail experience.
Prior health plan or pharmacy benefit management experience; internships may count.
Ability to consult with stakeholders.

Responsibilities

Assist in developing and implementing pharmacy programs that promote quality and cost-effective drug use.
Provide clinical consulting services and implement clinical information and education programs.
Assist with formulary development and conduct drug utilization analyses.
Support clinical pharmacists in managing drug utilization and core clinical programs, including drug utilization review and formulary/non-formulary management.
Research and synthesize detailed clinical data related to pharmaceuticals, and prepare and present therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.
Research medications and drug therapies and support development of evidence-based prior authorization criteria for pharmacy benefits.
Review escalated prior authorization requests, research medical necessity and appropriate coverage, and process non-formulary medication authorization reviews for clinical appropriateness.
Coordinate drug therapy interventions with clinical pharmacists to improve quality and outcomes and reduce the cost of care.
Identify and recommend improvements to the quality, effectiveness, and efficiency of pharmacy services.
Collaborate with pharmacists, pharmacy technicians, physicians, and other stakeholders to meet pharmacy program goals and objectives.
Direct and support internal ad hoc pharmacy management projects and projects with the contracted pharmacy benefit manager as needed.
Serve as a clinical resource to physicians and nurses on prospective, concurrent, and retrospective drug utilization reviews, dosage conversions, and therapeutic interventions.
Prepare information for network physicians.
Comply with regulatory and accreditation standards and internal guidelines, and remain current with standards pertinent to pharmaceuticals.
Perform other duties as assigned.