Clinical Formulary Specialist

EmpiRx Health, LLC•Montvale, NJ

21h•Hybrid

About The Position

EmpiRx Health is the leading clinically-driven pharmacy benefits management company. As the pioneer in value-based pharmacy care, EmpiRx Health puts its customers and members first by enabling them to take control of their pharmacy benefits, healthcare outcomes, and financial results. We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we do―and our population health solution delivers tailored strategies for our clients. Leveraging our newly launched, AI-powered pharmacy care platform, Clinically [https://clinically.co/]™, EmpiRx Health’s pharmacists and client experience teams provide the highest quality pharmacy care to our clients and their members. This enables benefits plan sponsors to keep their members healthy, happy, and productive, while substantially reducing prescription drug spending, which has been on an explosive growth trajectory in recent years. EmpiRx Health is in unprecedented growth, and we're seeking a highly skilled and experienced Clinical Formulary Specialist to join our dynamic team. In this pivotal role, you will collaborate closely with and support the Director of Clinical Risk and Services, ensuring that EmpiRx Health attains profound and sustainable savings for our clients while maintaining a commitment to clinically appropriate pharmacy care. The responsibilities of the Clinical Formulary Specialist encompass working in tandem with internal vendors to guarantee the upkeep of EmpiRx Health Formularies, Clinical Program edits, and Drug Lists. Externally, this pharmacist assumes the role of a Subject Matter Expert (SME), offering support to the EmpiRx Health Sales Team in navigating various sales opportunities.

Requirements

A Pharmacy Degree is required; PharmD is preferred, and an MBA or equivalent business qualification is advantageous.
Minimum of 3 years of professional experience in a Pharmacy Benefit Manager (PBM), Health Plan, or pharmacy benefit consulting company.
At least 2 years of hands-on experience analyzing raw prescription data.
Proficiency in Microsoft Office Suite.
Exceptional written and verbal communication skills.
Demonstrated strong presentation skills, with experience in public speaking.
Proficiently utilize third party platforms and reporting tools needed for successful management of patient cases and clients (e.g., SharePoint, Formulary Navigator, etc.)

Nice To Haves

Previous experience working with a Pharmacy and Therapeutics (P&T) Committee and/or Formulary Management.
Background or degree in analytics is a plus.
Specialized knowledge in prescription medication analysis and research, with a relevant license if applicable.
Board certifications in related fields are considered an advantage.

Responsibilities

Support Director of Clinical Risk and Services to ensure formulary strategies are implemented appropriately.
Assist in preparing quarterly P&T Committee submissions for formulary, clinical program edits changes and clinical review protocols.
Monitor the drug pipeline for new brand, biosimilar, generic, and indications, and review formulary placement, new to market block and clinical edit needs.
Act as a point of contact for the P&T Committee reviews for all internal teams through the final approval, meeting participation and post-meeting decision documents review.
Assist with Clinical Review protocol updates and revisions on an on-going basis.
Review quarterly P&T Committee changes and member impacts that are shared with Client Management for client and advisor notification.
Collaborate with necessary parties to ensure production of client facing formularies.
Collaborate with Clinical Account Executives in the creations, maintenance, and cataloguing of customized Drug Lists.
Coordinate the quarterly Population Health Dashboard campaigns with Analytics, IT, and Client Management and assist with relevant inquiries.
Actively participate in the pharmacy benefits sales process, including sales strategy meetings, providing clinical expertise to the team.
Review and approve Clinical Efficiency Assessments for RFP/RFI submissions.
Proficiently utilize and become a super-user of EmpiRx Health Clinical tools (e.g. Clinical Efficiency Assessment Tool, RxCurve 360 and Clinical Savings Tracker)
Utilize EmpiRx Heath applications for data access and information exchange and tracking with other departments (e.g. SalesForce, DOMO and Responsive/RFPIO)
Utilize external clinical and drug information tools to support and advance your clinical expertise as well as to stay abreast of current drug pipeline (e.g. IPD, UpToDate and MediSpan).
Act as a subject matter expert for the Care Management team for drug lists, P&T and formulary, and Clinical Efficiency Assessments .
Collaborate with Care Management colleagues and other departments (e.g. Client Management, Analytics) to ensure Clinical Service goals are achieved and successfully maintained.