Clinical Pharmacist (Open to hiring at Sr. level)

Wellmark, Inc.•Des Moines, IA

1d•Hybrid

About The Position

Use your strengths at Wellmark as a Clinical Pharmacist! About the role: As a Clinical Pharmacist, you'll be responsible for supporting the management of Wellmark’s clinical strategies to strengthen Wellmark Medical and Pharmacy Drug Programs with a focus on medical benefit drugs. You will serve as a drug information and clinical resource. In collaboration with the Health and Pharmacy Services team, Wellmark's Pharmacy and Therapeutics (P&T) Committee and other Wellmark stakeholders, you will be responsible for the development and maintenance of evidence-based policies, clinical drug programs, formulary management, and related P&T Committee activities to improve quality and affordability outcomes. This position will also partner closely with the Health Network team, so relationship and trust building skills are a must. Lastly, you will help develop and guide our medically benefited drug strategy and evaluate opportunities to reduce the total cost of care. About you: You have diverse clinical pharmacy experience and are excited about the opportunity to bring your medical benefit drugs experience to this role! You have a passion for positively impacting the health care system and doing what is right for our members. You are highly collaborative by nature and feel teamwork is essential for success. You are curious and thrive when you can use evidence-based research to drive decisions. You have high attention to detail and understand that one word variation can change an entire policy meaning. You have strong consultation and communication skills that lead you to excel in partnering with the right people to develop creative solutions. You aren’t afraid to present insights to various audiences and are skilled in adapting your communication approach. In this role, you will be a subject matter expert internally and externally for medical benefit drugs. You may be a top candidate if you have: Experience with pharmacy data and analytics Experience with medical claims and medical data Experience with developing and implementing pharmacy quality and cost savings programs Program implementation experience Strategic planning experience

Requirements

Bachelor's Degree in Pharmacy OR PharmD.
An active and unrestricted Pharmacy license in Iowa or South Dakota (individual must be licensed in the state in which they reside) is required within 6 months from date of hire.
3+ years of managed care pharmacy or pharmacy residency program experience. Broad understanding of the health care delivery system, managed care and pharmacy benefit management systems, plan design and overall operations.
Ability to make effective evidence-based decisions. Strong analytical, problem solving, and critical thinking skills.
Excellent written and verbal communication skills. Ability to effectively articulate complex information across all levels of an organization. Strong presentation skills.
Strong consulting and interpersonal skills to quickly build rapport, credibility, and collaborative partnerships with clinical peers, leaders, and stakeholders.
Proficient in Microsoft Office & intermediate Excel skills – e.g., pivot tables, trend analysis, formulas.
Strong knowledge of applicable rules, regulations, and guidelines, and maintain awareness of implications to pharmacy.
Strong organization and prioritization skills. Ability to manage multiple projects simultaneously and consistently meet deadlines.
Self-starter who can work well independently and as a member of a cross-functional team. Proven ability to work collaboratively with others.
Requires Active and Unrestricted Pharmacy License in a state within the United States
Bachelor's degree in Pharmacy OR PharmD.
An active and unrestricted Pharmacy License in a state within Iowa or South Dakota (individual must be licensed in the state in which they reside) is required within 6 months from date of hire.
5+ years of managed care pharmacy OR 2+ years of managed care pharmacy plus pharmacy residency program experience
Demonstrated coaching/mentoring experience, and broad understanding of the health care delivery system, managed care and pharmacy benefit management systems, plan design and overall operations. Advanced knowledge of medical literature retrieval and evaluation.
Proven subject matter expert in one or more managed care clinical pharmacy functions - e.g. Medical Benefit Drugs, Specialty Drugs, Government Programs.
Excellent analytical, problem solving, and critical thinking skills. Ability to independently make effective evidence-based decisions and coach/guide others.
Outstanding written and verbal communication skills. Ability to effectively articulate complex information across all levels of an organization, including senior leadership and non-clinical/technical audiences. Strong presentation skills.
Outstanding consulting and interpersonal skills to quickly build rapport, credibility, and collaborative partnerships with clinical peers, senior leaders, and stakeholders.
Proficient in Microsoft Office & intermediate Excel skills – e.g., pivot tables, trend analysis, formulas.
Continually expand pharmacy industry knowledge and ability to understand the clinical landscape, including impacts to programs/ services.
Strong organization and prioritization skills. Ability to manage multiple projects simultaneously and consistently meet deadlines.
Self-starter who can work well independently and as a member of a cross-functional team. Proven ability to work collaboratively with others.
Continually expand pharmacy industry knowledge and ability to understand the clinical landscape, including impacts to programs/ services.

Nice To Haves

Coaching/mentoring experience.
Experience partnering with sales or account management preferred.
Strategic planning experience.
Ability to respond to RFP/RFIs and serve as a clinical expert in strategic account meetings or finalist presentations.

Responsibilities

Develop and implement clinical pharmacy programs to promote quality and cost-effective drug use. Provide clinical consulting services to internal and external stakeholders and provide clinical information and education.
Support medical management and clinical pharmacy initiatives of Wellmark in support of commercial and exchange lines of business through research, analyses, and administration of clinical drug utilization management programs such as DUR and formulary/non-formulary management.
Prepare and present therapeutic class reviews and drug monograph information to the Wellmark Pharmacy and Therapeutics Committee.
Research and synthesize detailed clinical data related to medications and drug therapies and develop evidence-based clinical programs for both pharmacy and medical benefits.
Develop and coordinate appropriate drug therapy interventions that demonstrate quality improvement, reduction in the cost of care, and improved outcomes. Actively identify and make recommendations regarding ideas to improve the quality effectiveness and efficiency of pharmacy services offered by the health plan. Make recommendations to improve medication regimens as appropriate.
Direct and support internal ad hoc pharmacy management projects, as well as projects with the contracted pharmacy benefit manager, as needed.
Evaluate, prepare, and present therapeutic class reviews, drug monograph information, and recommendations to the Wellmark Pharmacy and Therapeutics (P&T) Committee and Formulary Assessment Committee.
Evaluate cost effectiveness, rebate proposals and distribution channels and make recommendations to the Formulary Assessment Committee for formulary additions or changes that support Wellmark's goal of providing access to the most comprehensive and cost- effective formulary options.
Perform clinical review of medication appeal requests. Utilizes clinical experience and skills in a collaborative process to apply the appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render appropriate coverage determination.
Serve as a clinical resource to other physicians, nurses, and other internal stakeholders on areas such as prospective, concurrent, and retrospective DURs, drug related fraud, waste, and abuse cases, and provide clinical support for therapeutic interventions.
In partnership with Marketing and Communications Team, prepare and communicate information to network providers.
Comply with regulatory standards, accreditation standards and internal guidelines, remain current and consistent with the standard pertinent to pharmaceuticals.
Other duties as assigned.