Clinical Pharmacist Consultant

Cambia Health Solutions; Burlington (WA); Remote; USD 120,000 - 164,000; Full time

Job summary

Cambia Health Solutions is seeking a Clinical Pharmacist Consultant to enhance medication decision-making processes and optimize treatments across various states. This role requires advanced clinical expertise to evaluate medications, develop strategies, and collaborate across teams, ensuring that members receive high-quality pharmacy services. Join a team dedicated to person-focused healthcare, leveraging your skills to improve patient outcomes and create sustainable healthcare solutions.

Benefits

Medical, dental and vision coverage

Annual employer contribution to health savings account

Generous paid time off

401(k) plan with company match

Paid parental leave

Wellness programs

Commute and parking benefits

Work-from-home options

Qualifications

• 3-5 years of experience in a clinical acute care/hospital setting.
• Active and unrestricted pharmacy license.
• Pharmacy residency or advanced degree preferred.

Responsibilities

• Evaluate medication coverage recommendations based on evidence and policies.
• Develop clinical documentation and educational materials for medication management.
• Deliver high-quality clinical services for Medication Benefit Management.

Skills

Clinical pharmacy background

Project management skills

Communication skills

Healthcare economics knowledge

Regulatory knowledge

Education

Doctor of Pharmacy (PharmD)

Bachelor’s degree in Pharmacy

Job description

Clinical Pharmacist Consultant Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia’s dedicated team of Clinical Pharmacist Consultants are living our mission to make health care easier and lives better. As a member of the Pharmacy Services team, our Clinical Pharmacist Consultants provides clinical pharmacy expertise to guide evidence-based medication decisions optimizing efficacy, safety, and affordability. Evaluates coverage recommendations for prior authorizations, appeals, claim reviews, and audits based on policies and contracts. Serves as a resource for staff on clinical questions and may conduct outreach to members and providers regarding beneficial clinical programs. Assists in developing clinical strategies for formulary management, utilization management, therapy programs, quality initiatives, and integrated pharmacy management. Advanced responsibilities include healthcare cost analysis, developing position papers, coverage policies, formulary documents, and leading cross-functional projects that enhance safety, quality, and affordability of pharmacy benefits – all in service of making our members’ health journeys easier.

Are you a pharmacist looking to leverage your clinical expertise beyond traditional settings?Are you ready to use your clinical knowledge to influence healthcare decisions at a system level? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

• Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) or related field

• 3-5 years of experience in clinical acute care/hospital setting or equivalent combination of education and experience

• Pharmacy license. Successful completion of a pharmacy residency or advanced degree in health-related field preferred. Must be an active and unrestricted licensed pharmacist in state of practice

Skills and Attributes:

• Clinical pharmacy background with demonstrated therapy skills and knowledge in clinical care settings

• Proven success managing professional relationships in managed care systems, medical groups, hospitals, or related organizations

• Excellent verbal/written communication, business analytical, and project management skills

• Knowledge of pharmaceutical products (orals, injectables, infusions, chemotherapy) and relevant healthcare regulations (DOLI, PPACA, HIPAA)

• Strong understanding of healthcare economics, financing, industry dynamics, and medication reimbursement

• Familiarity with health plan structures, benefit designs, Medicare/CMS regulations, and healthcare coding systems (ICD-9, CPT, HCPCS, NDC)

• Knowledge of compliance activities, legislative/regulatory matters, health insurance operations, and legal issues

• Ability to collaborate in cross-functional teams to improve clinical programs, enhance processes, and share information

• Capable of working independently, prioritizing tasks, meeting deadlines, and achieving operational goals

What You Will Do at Cambia:

• Delivers high-quality pharmacy clinical services for Medication Benefit Management, including peer clinical reviews, peer-to-peer conversations, and evaluation of cost-containment and quality improvement opportunities.

• Provides coverage recommendations for medications based on policies, contracts, and evidence-based medicine to determine optimal efficacy and safety value.

• Develops educational materials for members about medication coverage choices, comparative effectiveness, and coverage determinations.

• Analyzes healthcare cost information and prescribing patterns through medication utilization reports to forecast trends.

• Develops clinical documentation including position papers, coverage policies, monographs, and formulary recommendations based on scientific literature.

• Presents clinical positions to internal/external decision-making bodies such as Pharmacy and Therapeutics Committee.

• Identifies, develops, and implements cross-functional programs related to pharmacy benefits that impact safety, quality, and affordability, including supporting clinical programs and providing expertise to Case Management.

The expected hiring range for a Clinical Pharmacist Consultant is $120,700 - $163,300 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $113,000 - $185,000 .

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:

• Work alongside diverse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

Learn more about our benefits.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email [e-mail] . Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy .