Clinical Operations Pharmacist

MedImpact Healthcare Systems, Inc.•San Diego, CA

2d•$108,515 - $196,412•Onsite

About The Position

The Clinical Operations Pharmacist provides analytic/technical support to optimize the clinical quality and cost-effectiveness of drug and medical therapy, as applicable, for client plan sponsors and their members. Focuses on rational management of drug utilization by employing analytical tools and an evidence-based approach to achieve lower net cost, better health outcomes, and higher levels of satisfaction for plan sponsors, and their members. The role manages operational aspects of clinical operations, strategic initiatives, projects, and/or programs. This position focuses on supporting analytic, technical, and operational aspects of clinical management. The role collaborates across the organization. The role relies on data and performance indicators, as well as experience and judgment, to identify and promote performance improvement opportunities which attain the aligned goals of MedImpact and assigned clients.

Requirements

PharmD and 3+ years’ experience or equivalent combination of education and experience, and 1 year of SME in respective areas
Knowledge of Microsoft Office Suite and a proficient knowledge of Access, Excel and relational databases.
Valid Registered Pharmacist in the State of California or equivalent state.
Must be fluent in Spanish (speaking, reading and writing)
Analytical skills with Health Informatics experience preferred.
Part D experience required
Advanced Excel skills required
Other technical skills preferred (Access, SQL or Python)
Experience working with PBM or health plans.
Experience in promoting disease management and/or drug cost management programs preferred.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write reports, business correspondence, and procedure manuals.
Ability to effectively present information to top management, public groups, and/or boards of directors.
Composure
Decision Quality
Organizational Agility
Problem Solving
Customer Focus
Drive for Results
Peer Relations
Time Management
Dealing with Ambiguity
Learning on the Fly
Political Savvy

Nice To Haves

Health Informatics experience preferred.
Other technical skills preferred (Access, SQL or Python)
Experience in promoting disease management and/or drug cost management programs preferred.

Responsibilities

Manages, contributes and assists in current priority, projects, programs or initiatives as defined by supervisor.
Provides clinical subject matter expertise and combines with business operations knowledge to ensure clinical and business appropriateness and success; Assists with related analytic needs to support recommendations being considered by assigned clients that align with both the clients’ and MedImpact’s mutual goals of lower net costs and high clinical quality.
The strategic recommendations may include: benefit design and formulary analysis and suggestions, provision of clinical drug information, client P&T support and participation, recommendations for rational drug formulary positioning, on-line system edits and restrictions, on-going clinical product evaluations, and recommendations regarding client pharmacy benefit utilization and performance trends; Supports clinical consultative services in accordance with contracted clinical services.
The role is an integral part of designing, developing, and driving the clinical components of their assigned account team’s strategic and financial goals.
Ongoing focus will be centered on using a variety of analytical tools and clinical resources to identify opportunities which simultaneously improve the plan sponsor’s quality-focused and financial performance metrics; Supports analytics necessary for MedImpact’s evidence-based interventions and communication programs to clients.
Provides documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g. lower net cost, generic programs, QA programs, clinical and specialty programs, and applicable rebate management); Coordinates clinical utilization analyses, in collaboration with key stakeholders, to support presentations to clients.
Ensures timely and accurate review of plan data, according to policy, with appropriate intervention recommendations; Supports, implements, and maintains DUE, DUR, and QI programs to meet plan, HEDIS, and NCQA guidelines; Coordinates clinical support of Drug Formulary and Preferred Drug Lists during plan sponsor’s implementation and maintenance of business in collaboration with the Clinical Program Manager (Client Team); Supports recommended clinically appropriate initiatives to optimize the value of MedImpact’s rebate administration program for clients while delivering on the lower net cost goal; Supports MedImpact P&T Committee quarterly meetings and weekly MediSpan drug updates.