Clinical Pharmacist IV

Medica•Minnetonka, MN

1d•Hybrid

About The Position

Medica is a nonprofit health plan serving more than a million members in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. The Clinical Pharmacist works collaboratively with internal and external stakeholders to advance pharmacy strategy, utilization management, clinical programs, regulatory requirements, and pharmacy performance. The role applies clinical expertise and data analysis to identify opportunities, evaluate pharmacy spending and trend drivers, develop mitigation strategies, and support initiatives that improve clinical and financial outcomes. It also partners with PBMs on formulary execution and serves as a clinical pharmacy subject matter expert across a matrixed organization. Other duties may be assigned. This is an office role requiring onsite work an average of three days per week. Candidates may be located near Medica offices in Minnetonka, Minnesota; Madison, Wisconsin; St. Louis, Missouri; or Omaha, Nebraska. The full salary grade is $113,400–$194,400, with a typical hiring range of $113,400–$170,100. Placement depends on factors including education, experience, certifications or licensure, scope and responsibility, internal pay equity, and market data. The position may also be eligible for incentive compensation.

Requirements

Bachelor's degree in Pharmacy required.
At least 5 years of related pharmacy experience beyond the degree.
Active pharmacist license required.

Nice To Haves

PharmD or equivalent experience in a related field.
Experience in pharmacy operations, clinical programs, utilization management, analytics, regulatory affairs, or related health plan/PBM functions.
Strong knowledge of pharmacy benefit management, formulary execution, clinical pharmacy programs, pharmacy utilization, and factors influencing pharmacy spending and trends.
Ability to interpret pharmacy reporting and translate data into meaningful business and clinical insights; proficiency with reporting and data-analysis tools.
Ability to analyze pharmacy spending, utilization, and trend drivers and develop practical mitigation recommendations.
Knowledge of regulatory and compliance requirements affecting pharmacy services.
Strong written, verbal, presentation, and stakeholder communication skills.
Ability to collaborate and influence without direct authority in a matrixed, multidisciplinary environment.
Highly organized, with the ability to manage multiple projects and priorities while maintaining attention to detail.
Self-starter able to work through ambiguity and changing business or regulatory environments.
Creative, analytical problem solver with a demonstrated track record of achieving results.

Responsibilities

Monitor pharmacy utilization, spending, and trend performance; identify cost drivers, emerging patterns, and opportunities across the pharmacy benefit.
Work with Analytics and business stakeholders on spending and trend analysis, including forecasting, utilization impact assessment, variance analysis, and actionable insights.
Develop and support evidence-based strategies to mitigate adverse pharmacy trends and improve clinical and financial performance, including clinical program and utilization management opportunities.
Serve as a clinical pharmacy subject matter expert and advisor to internal partners, translating complex pharmacy information and data into clear recommendations.
Oversee and coordinate pharmacy-related operational, regulatory, and compliance activities, including reporting, submissions, audits, transparency requests, and documentation.
Collaborate with pharmacy vendors, PBM partners, provider organizations, and other external stakeholders to support pharmacy program operations and performance.
Partner with PBMs on formulary execution, including implementation and maintenance of formulary changes, operational alignment, issue resolution, and ongoing monitoring.
Identify and communicate performance improvement opportunities and support implementation through cross-functional collaboration.
Respond professionally and promptly to member, provider, client, and internal stakeholder questions or issues related to pharmacy services.
Participate in clinical pharmacy meetings, workgroups, and cross-functional initiatives that advance strategic, operational, and performance objectives.
Evaluate clinical literature and draft clinical drug information to support formulary placement and utilization management strategies for drug classes presented for P&T approval.
Perform other duties as assigned.