Clinical Pharmacist

Hawaii Medical Service Association • Honolulu, HI

6d

About The Position

Supports implementation and ongoing management of formulary, utilization management, and clinical policy programs within an assigned line of business. Evaluates the clinical implications of pharmacy program changes and emerging utilization trends, maintains alignment between clinical strategy and line-of-business needs, and identifies opportunities to improve clinical and financial outcomes.

Conducts clinical reviews of medications, therapeutic classes, and utilization patterns; develops formulary evaluations and clinical recommendations; evaluates utilization management programs; and helps develop, implement, and maintain clinical policies and coverage criteria. Reviews pharmacy utilization data, emerging trends, and clinical outcomes to identify intervention opportunities and develop recommendations that improve member outcomes and manage pharmacy trend.

Collaborates with Pharmacy Operations, Pharmacy Solutions, Pharmacy Performance, data analysts, internal stakeholders, and external vendor partners. Supports Pharmacy & Therapeutics (P&T) Committee activities, provides clinical consultation, participates in cross-functional initiatives, and assists with regulatory, accreditation, and compliance activities affecting pharmacy clinical programs. Performs other duties as 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 identifying issues and collecting, analyzing, and interpreting data.
• Proficiency in developing and executing 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 for an assigned line of business.
• Evaluate the clinical implications of pharmacy program changes and emerging utilization trends, and 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 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 on formulary, utilization management, and pharmacy program questions.
• Participate in cross-functional initiatives requiring pharmacy clinical expertise.
• Assist with regulatory, accreditation, and compliance activities affecting pharmacy clinical programs.
• Perform other miscellaneous responsibilities and duties as assigned or directed.

What This Job Offers

• Job Type: Full-time