Clinical Pharmacist: Formulary & Utilization Management

JobRx, Inc.; Canton (OH); Hybrid; USD 90,000 - 120,000; Full time

Job summary

JobRx, Inc. is seeking a Clinical Pharmacist to support management of the pharmacy lines of business, collaborating with multi-disciplinary teams and adhering to organizational and regulatory policies.

You will evaluate formulary placement, utilization management tools, monitor FDA approvals, and write drug monographs for Pharmacy and Therapeutics committee review. The role includes daily program activities and data-driven decision making.

Qualifications

• Bachelor of Science or Doctor of Pharmacy with active and unrestricted pharmacist license in Ohio.
• Residency or fellowship preferred.
• 2–3 years experience with a health plan or PBM, preferred.

Responsibilities

• Translate clinical information into functional specifications within a clinical rule set to be implemented at pharmacy point-of-care programs, including formulary development, medication compliance, prior authorization, step therapy, adherence, drug utilization review, dose optimization, and reviewing prescriber patterns.
• Oversee aspects of the pharmacy rebate and pharmacy network program.
• Collaborate with the Part D clinical pharmacist, medical management programs, operational, and customer service departments.
• Implement legislative updates.
• Manage the Medication Therapy Management program.
• Continuously review, recommend, and implement process improvements as needed or directed.
• Analyze data and provide outcomes to the team and clients.
• Uphold professional standards to enhance departmental development.
• Practice ethical conduct.
• Support formulary administration audits with Compliance or other applicable organizations.
• Lead formulary change processes within URAC/NCQA/CMS guidelines.
• Participate in the Pharmacy and Therapeutics (P&T) Committee as an ad hoc member.

Skills

Problem solving

Multitasking

Communication skills

Adaptability

Attention to detail

Excel proficiency

Education

PharmD or BS in Pharmacy

Residency preferred

Tools

Microsoft Excel

Microsoft Office Suite

Job description

JobRx, Inc. is seeking a Clinical Pharmacist to support management of the pharmacy lines of business, collaborating with multi-disciplinary teams and adhering to organizational and regulatory policies.

You will evaluate formulary placement, utilization management tools, monitor FDA approvals, and write drug monographs for Pharmacy and Therapeutics committee review. The role includes daily program activities and data-driven decision making.