Clinical Pharmacist, Pharmaceutical Services Consultant
About The Position
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. The Clinical Pharmacist, Pharmaceutical Services Consultant will evaluate new-to-market medications, develop clinical recommendations, and propose utilization criteria for HCA New Mexico to support New Mexico Medicaid members.
Requirements
- PharmD degree.
- Minimum of two (2) years’ experience with Pharmacy Benefit Management, Prior Authorization processes, and knowledge of pharmacy point-of-sale systems and adjudication rules.
- Proficiency with Microsoft 365 (Word, Excel, PowerPoint, SharePoint).
Nice To Haves
- Knowledge of Pro DUR and Retro DUR.
- Understanding of formulary management practices.
- Familiarity with FDB (First Databank).
- Medicaid program experience.
- Strong clinical data analysis skills.
Responsibilities
- Proactively deliver new drug analyses and recommendations, including coverage guidance, clinical prior authorization criteria, pharmacoeconomic insights, and pharmacy practice guidelines.
- Provide ad hoc data analyses and query results to HCA New Mexico to support clinical program development and decision-making.
- Lead regularly scheduled client clinical meetings and remain available during business hours to address client questions and requests.
- Review rejected claims and provide clinical recommendations for prior authorization determinations.
- Collaborate with Retro DUR pharmacists to implement new interventions, create ad hoc reports, and address inquiries from clients, providers, and internal staff.
- Partner with the account team to update clinical interventions based on evolving treatment guidelines and evidence-based recommendations.
- Work with the IT team to ensure accurate configuration of clinical recommendations.
- Supply required data for annual CMS survey responses.
- Present clinical updates quarterly at state DUR Board meetings.
Benefits
- Health and Welfare Benefits: Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment.
- Retirement Savings: We will support you as you save for your future.
- Employee Discounts: We offer you access to a vast selection of global, national, and local discounts on merchandise, services, travel, and more.
- Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
- Paid Training: Earn while you learn and continue to grow with access to award-winning learning platforms throughout your Conduent career.
- Paid time off: We provide attractive paid time off packages designed for you to enjoy your life away from work.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Ph.D. or professional degree
Number of Employees
1-10 employees
