Pharmacy Resident - Managed Care

MedImpact Healthcare Systems, Inc.•San Diego, CA

2d•$19 - $30•Onsite

About The Position

MedImpact’s Managed Care Pharmacy Residency Program is a one-year program designed to develop future managed care leaders by building a strong foundation in clinical and managed care principles. The Pharmacy Resident supports the Government Programs and Services team and other departments through managed care learning experiences, rotations, and longitudinal projects across clinical operations, utilization and formulary management, clinical account services, quality assurance and improvement, government program management, analytics, and research. The role includes evaluating prior authorization requests, supporting clinical quality and government programs, conducting cost-savings and member-impact analyses, assisting with formulary and quality initiatives, and preparing and presenting materials for Pharmacy and Therapeutics Committee meetings. The resident also completes a longitudinal research project for presentation at the AMCP Annual Meeting. This is a full-time, non-exempt position, typically scheduled Monday through Friday from 8:00 a.m. to 5:00 p.m., with occasional overtime and availability for nights, weekends, or holidays as required. It is based on-site at the San Diego headquarters or another company location; remote work may be approved by management based on business requirements. Domestic travel of up to 25% is required.

Requirements

PharmD from an ACPE-accredited school of pharmacy.
Obtain a Registered Pharmacist license in the state of residence and Kentucky by October 1 of the program year.
Proficiency with Microsoft Office Suite.
Strong analytical and problem-solving capabilities.
Excellent communication and presentation skills.
Ability to work independently and as part of a team.
Knowledge of PBM operations, drug formulary systems, and healthcare regulations.
Ability to analyze and interpret business periodicals, professional journals, technical procedures, and governmental regulations.
Ability to effectively present information to top management, public groups, and/or boards of directors.
Ability to work with mathematical concepts, including probability, statistical inference, and basic algebra and geometry.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Ability to work overtime from time to time and nights, weekends, or holidays as required.
Ability to travel domestically up to 25% of the time.

Responsibilities

Perform cost-savings and member-impact analyses after learning benefit design and utilization management strategies.
Contribute to clinical quality programs, including Drug Utilization Review, Transitions of Care, and initiatives to improve HEDIS and CMS Star Ratings.
Support clients by developing and implementing quality and cost-savings initiatives and managing custom formularies across all lines of business.
Participate in government program management to evaluate and facilitate regulatory programs.
Perform quality program oversight, develop quality improvement initiatives, and support oversight audits.
Evaluate prior authorization requests and learn the regulatory requirements governing prior authorization reviews, including four hours of weekly staffing.
Assist with Pharmacy and Therapeutics material preparation and weekly drug updates.
Present at MedImpact Pharmacy and Therapeutics Committee meetings.
Develop presentation skills, lead meetings, learn to manage projects, and navigate corporate complexities.
Conduct a longitudinal research project for presentation at the AMCP Annual Meeting.