About The Position

The Clinical Pharmacist, Clinical Pharmacy Strategy Team - CarelonRx is responsible for developing and implementing pharmacy programs. CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.

Requirements

  • Requires BA/BS in Pharmacy.
  • Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.
  • Requires a registered pharmacist.
  • Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
  • Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US, unless they are command-sanctioned activities.
  • For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position.

Nice To Haves

  • Experience with medical and pharmacy drug cost containment or formulary strategy in a health plan or PBM setting.
  • Strong working knowledge of traditional and high-cost specialty drugs, including biosimilars.
  • Ability to translate complex clinical and regulatory concepts into business strategies.
  • PharmD.

Responsibilities

  • Design and implement innovative pharmacy programs to manage traditional and specialty drug costs under both medical and pharmacy benefits.
  • Research and synthesize detailed clinical data related to pharmaceuticals.
  • Prepare and present therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.
  • Serve as a clinical resource to other pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.
  • Prepare information for network physicians.

Benefits

  • merit increases
  • paid holidays
  • Paid Time Off
  • incentive bonus programs
  • medical
  • dental
  • vision
  • short and long term disability benefits
  • 401(k) +match
  • stock purchase plan
  • life insurance
  • wellness programs
  • financial education resources
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