About the position
Medica's Clinical Pharmacists works in conjunction with key internal and external stakeholders to drive the strategy supporting the pharmacy formularies, utilization management (UM), and clinical programs. Areas of focus include Commercial formulary optimization, pharmacy pipeline monitoring/ utilization predictions, formulary assessment and new UM policy development to support formal Pharmacy & Therapeutics (P&T) Committee approvals. The incumbent will keenly anticipate key market events and incorporate into strategic recommendations in consideration with local or regional trends. Strategic goals are focused on clinical and financial performance, and collaborative development of success metrics to evaluate the performance of each program and initiative. The individual in this role will ensure that such work is done in compliance with applicable state and federal regulations.
Responsibilities
- Monitor the drug pipeline and partner with Analytics to predict utilization impact
- Evaluate clinical literature to draft clinical drug information to support formulary placement and UM strategies for all classes of drugs presented for approval at P & T
- Partner with internal clinical pharmacy team and Analytics to analyze pharmacy trends to develop negative trend mitigation strategies
- Understand and promote clinical pharmacy program strategies such as biosimilar utilization optimization
- Serves as clinical pharmacy subject matter expert and advisor
- Actively participate in internal and external clinical pharmacy meetings necessary to support key accountabilities
- Educate and promote targeted performance improvement opportunities across the enterprise
- Oversees and partners with key stakeholders in formulary management, clinical programs, and regulatory and compliance needs
Requirements
- Bachelor's degree in Pharmacy required; PharmD preferred
- 7+ years of related experience
- Prior experience with P&T/formulary management from a health plan or PBM standpoint is required
- Experience working in a matrixed or multi-disciplinary environment is preferred
- Valid, registered pharmacy license (in any state)
Benefits
- Competitive medical, dental, vision
- PTO
- Holidays
- Paid volunteer time off
- 401K contributions
- Caregiver services
- Generous total rewards package
