Clinical Pharmacist

HMSA • Honolulu, HI

6d

About The Position

The Clinical Pharmacist supports clinical programs for an assigned line of business, including formulary, utilization management, and clinical policy programs. The role evaluates clinical implications of program changes and utilization trends, maintains alignment between clinical strategy and business needs, and identifies opportunities to improve clinical and financial outcomes.

The position reviews medications, therapeutic classes, pharmacy utilization patterns, clinical outcomes, and emerging therapies. It develops formulary evaluations, clinical recommendations, policies, and coverage criteria, and evaluates utilization management programs for potential refinement. The Clinical Pharmacist collaborates with data analysts and cross-functional teams, supports operational implementation and strategic readiness, provides clinical consultation to internal stakeholders and vendor partners, and contributes to Pharmacy & Therapeutics Committee activities and regulatory, accreditation, and compliance work. Other responsibilities may be assigned or directed.

Requirements

• Pharmacy degree and two years of experience as a pharmacist, or an equivalent combination of education and experience.
• Knowledge of health care industry trends.
• Knowledge of basic relevant statistical analyses.
• Proficiency in issue identification and data collection, analysis, and interpretation.
• Proficiency in development and execution of operational process flows.
• Strong oral and written communication skills.
• Intermediate working knowledge of Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook.
• Hawaii Pharmacist licensure.

Responsibilities

• Support implementation and ongoing management of formulary, utilization management, and clinical policy programs within an assigned line of business.
• Evaluate clinical implications of pharmacy program changes and emerging utilization trends.
• Maintain alignment between clinical strategy and line-of-business needs.
• Identify and communicate opportunities to improve clinical and financial outcomes.
• Conduct clinical reviews of medications, therapeutic classes, and utilization patterns.
• Develop formulary evaluations and clinical recommendations.
• Evaluate utilization management programs and identify opportunities for refinement.
• Develop, implement, and maintain clinical policies and coverage criteria.
• Review pharmacy utilization data, emerging trends, and clinical outcomes to identify opportunities for intervention.
• Evaluate the clinical impact of new therapies, utilization patterns, and pharmacy initiatives.
• Develop recommendations designed to improve member outcomes and manage pharmacy trend.
• Collaborate with Data Analysts to interpret findings and evaluate potential opportunities.
• Partner with Pharmacy Operations to support operational implementation of clinical decisions and policy updates.
• Collaborate with Pharmacy Solutions on strategic initiatives and readiness planning.
• Support Pharmacy Performance with clinical interpretation of PBM programs, formulary changes, and utilization management performance.
• Serve as a clinical resource for internal stakeholders and external vendor partners.
• Support preparation of materials and recommendations for Pharmacy & Therapeutics (P&T) Committee activities.
• Provide clinical consultation regarding formulary, utilization management, and pharmacy program questions.
• Participate in cross-functional initiatives requiring pharmacy clinical expertise.
• Assist with regulatory, accreditation, and compliance activities impacting pharmacy clinical programs.
• Perform other miscellaneous responsibilities and duties as assigned or directed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Ph.D. or professional degree