Clinical Pharmacist II, COMM and Exchange

Mass General Brigham Incorporated; Somerville, Northern (MA, KY); Hybrid; USD 134,000 - 164,000; Full time

Job summary

Mass General Brigham Health Plan is seeking a Clinical Pharmacist II for COMM/Exchange to develop and maintain the pharmacy formularies to ensure appropriate coverage and cost effectiveness. You will support committee activities and collaborate with the PBM to align clinical strategies with plan goals.

The role emphasizes formulary trend management, implementation of clinical programs, and cross-team collaboration within Mass General Brigham Health Plan.

Qualifications

• Doctor of Pharmacy degree required.
• Active Pharmacist License required.
• 3–5 years of managed care pharmacy experience preferred.

Responsibilities

• Develop and maintain COMM/Exchange pharmacy formularies to ensure appropriate coverage and cost effectiveness.
• Support Pharmacy and Therapeutics committee; prepare materials for committee members and collaborate with PBM.
• Chair the Drug Coverage Committee; develop agenda and materials; ensure quorum and timely votes.
• Develop, analyzes, reports on clinical programs; coordinate between Pharmacy and other teams within Mass General Brigham Health Plan.
• Lead managed care programs such as prior authorization and quantity limitations; ensure regulatory compliance.

Skills

Leadership

Communication

Healthcare knowledge

Education

Doctor of Pharmacy

Job description

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

The Clinical Pharmacist II for COMM/Exchange will be responsible for developing and maintaining the COMM and Exchange pharmacy formularies to ensure appropriate coverage and cost effectiveness.

Essential Functions

• -Pharmacy and Therapeutics committee support; preparing materials for committee members and collaborating with the PBM on materials that will be presented.
• -Participates as the Chair of the Drug Coverage Committee. Develops agenda and materials with the Clinical Pharmacy team that will be presented. Presents materials that are within scope and ensures committee attendees meet the quorum, and votes are received timely. Assists in the development, implementation, and maintenance of clinical programs.
• -Formulary trend management:
  • o Develops and implements clinical pharmacy strategies which result in high-quality, cost-effective pharmacy management and outcomes
  • o Develops, analyzes, reports on clinical programs, handles, and coordinates between Pharmacy and other collaborators throughout Mass General Brigham Health Plan.
  • o Develops, implements, and leads managed care programs such as prior authorization and quantity limitations programs
  • o Ensures clinical compliance with law and regulatory bodies
  • o Develops educational materials, newsletters, member, and provider talking points, and disseminates clinical information for both internal and external audiences.
  • o Participates in other committees as requested
  • o Works with the Clinical Pharmacy Associates to ensure coding is accurate and reflects the intent of the plan
• -Supports other clinical pharmacy team functions as assigned.
• -Participates in department quality improvement efforts.
• -Performs other duties as assigned.
• -Complies with all policies and standards.

Qualifications

Education

Doctor of Pharmacy required

Licenses and Credentials

Pharmacist License required

Experience

At least 3-5 years of experience working as a managed care pharmacist preferred

Knowledge, Skills, and Abilities

Strong, demonstrated track record of the ability to execute on time, on budget, and on scope. Strong aptitude for technology-based solutions. Ability to inject energy, when and where it’s needed. Current in healthcare trends. Demonstrated forward, visionary thinking; ability to see “what is” and envision “what could be.” Ability to develop, introduce, defend, and gain support for new ideas and approaches. Excellent leadership skills and leadership track record. Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required. Ability to view the long-range trends and cycles of the business and industry and see the “big picture.” Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions. Ability to challenge the status quo and drive innovative thinking, and the capability to successfully implement strategy. Excellent interpersonal skills, including the ability to influence others at all levels of an organization. Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.

Additional Job Details (if applicable)

Working Conditions

This is a full-time role with a Monday through Friday schedule, generally 8:30 AM to 5:00 PM Eastern Time

This position is eligible for remote work from approved U.S. locations, subject to organizational requirements

Remote employees must maintain a stable internet connection and a secure, private, quiet workspace appropriate for handling confidential and protected health information

Remote workspace requirements, including privacy and security standards, may be verified in accordance with organizational policy

Remote Type

Remote Type Remote Work Location 399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular Work Shift Day (United States of America)

Pay Range

Pay Range $134,316 - $164,087.04/Annual Grade 7

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

EEO Statement:

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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