Clinical Pharmacist, Formulary Strategy & PBM Compliance

Abarca Health LLC.; San Juan (PR); Hybrid; USD 95.000 - 125.000; Vollzeit

Zusammenfassung

Abarca Health LLC in Puerto Rico is seeking a Clinical Pharmacist for Formulary Services to develop and implement Medicare, Medicaid, and Exchange formulary programs while ensuring compliance with regulatory guidelines.

You will lead configuration setup for new client implementations, resolve adjudication issues, and provide client-facing demos of the PBM platform, collaborating with teams to meet client needs and drive formulary design improvements.

Qualifikationen

• Doctoral Degree in Pharmacy is required.
• Current/Active Pharmacy License is required.
• 3+ years of formulary management experience in clinical operations and PBM.
• Experience working within clinical scenarios.
• Excellent oral and written communication skills.
• Hybrid work model with required on-site days at Puerto Rico location.

Aufgaben

• Develop and implement Medicare, Medicaid, and Exchange formulary programs.
• Ensure compliance with external regulator guidelines to keep operations compliant.
• Independently resolve adjudication and processing issues and advise on root cause and corrective action.
• Provide client-facing demos on the PBM configuration platform.
• Lead configuration setup for new client implementations and changes for existing clients.
• Provide consultative support to clients and internal teams.
• Monitor workload assignments and optimize configuration processes.
• Identify opportunities to improve inventory management and standards for configuration.

Kenntnisse

Oral and written communication

Clinical operations experience

Formulary management

Pharmacy benefit management

Ausbildung

Doctoral Degree in Pharmacy

Active Pharmacy License

Master’s Degree

Jobbeschreibung

Abarca Health LLC in Puerto Rico is seeking a Clinical Pharmacist for Formulary Services to develop and implement Medicare, Medicaid, and Exchange formulary programs while ensuring compliance with regulatory guidelines.

You will lead configuration setup for new client implementations, resolve adjudication issues, and provide client-facing demos of the PBM platform, collaborating with teams to meet client needs and drive formulary design improvements.