Managed Care Resident - Remote - Express Scripts (Health Plans)
About The Position
The Health Plan Pharmacy Resident participates in a 12-month post-PharmD residency designed to provide a comprehensive managed care experience with a focus on clinical strategy, formulary management, and health plan account management. As an integral member of the Health Plan Delivery team, the resident will collaborate with health plan clients, account teams, and cross-functional partners to develop and execute clinical strategies that improve member outcomes, optimize pharmacy spend, and support client goals. The residency provides hands-on experience in client consultation, trend management, formulary strategy, quality initiatives, and managed care operations across Commercial, Medicare, Medicaid, and Marketplace lines of business. Through this residency, participants will develop the clinical, strategic, and client-facing skills needed for future careers in managed care pharmacy, clinical consulting, account management, formulary strategy, and health plan leadership.
Requirements
- Pharm.D. degree from an ACPE-accredited college or school of pharmacy
- Pharmacy Licensure in any US State (within 90 days of residency start)
- Proficiency in Microsoft office, specifically Microsoft excel and PowerPoint
- Proficiency in written and verbal communications
- Strong career interest in Managed Care pharmacy
- Must upload/attach Pharmacy School Transcript and Resume to application for review
- If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
Nice To Haves
- The dynamic partnership between PBMs and health plans
- Strategies for supporting and consulting with health plan clients
- Effective collaboration across clinical, operational, and account management teams
- Formulary strategy across Commercial, Medicare, Medicaid, and Marketplace markets
- Clinical and financial decision-making within managed care pharmacy
- Fundamentals of account management and client consulting
- Approaches to achieving client goals and driving measurable outcomes
- The clinical, operational, and business foundations of managed care pharmacy
Responsibilities
- Collaborating with health plan clients and account teams to develop and execute clinical strategies
- Analyzing pharmacy and medical trends and recommending solutions to improve clinical and financial outcomes
- Supporting formulary, utilization management, and specialty drug management initiatives
- Evaluating and implementing clinical programs and innovative healthcare solutions
- Contributing to quality improvement initiatives, including Stars and regulatory market strategies
- Participating in client presentations, strategic planning discussions, and cross-functional workgroups
- Supporting value-based contracting, pipeline management, and emerging therapy assessments
- Monitoring legislative and regulatory developments impacting managed care pharmacy
- Contributing to projects, research, and presentations that support organizational and client objectives
Benefits
- medical
- vision
- dental
- well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- a minimum of 18 days of paid time off per year
- paid holidays
- leaves of absence
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Ph.D. or professional degree
