Clinical Pharmacist - Provider Liaison (Managed Care)

Prime Therapeutics; Cheyenne (WY); Presencial; USD 108.000 - 184.000; Jornada completa

Descripción de la vacante

Prime Therapeutics is seeking a Clinical Pharmacist to deliver clinical and regulatory analysis supporting operations and formulary management, with opportunities to influence benefit plans and compliance. You will partner with internal and client teams to design testing scenarios, perform QA, support drug utilization data, and assist with formulary changes while maintaining regulatory standards.

Eligibility includes PharmD or BS Pharmacy, 1 year of experience, and an active pharmacist license.

Formación

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
• 1 year of work experience in clinical, retail, hospital, or managed care
• Current Pharmacist license to practice in the applicable state(s)
• Knowledge of AS400, queries, and Lotus Notes
• Strong analytical and problem-solving skills with attention to detail and quality
• Ability to manage multiple projects simultaneously under pressure with strict timelines
• Proficiency with Microsoft Excel and Word

Responsabilidades

• Partner with internal stakeholders and clients to develop and maintain project and benefit plan testing scenarios, including utilization management and specialty offerings
• Interpret project requests to determine feasibility, document requirements, and provide technical solutions
• Conduct testing, including test plan creation, test execution, and User Acceptance Testing for quality assurance
• Identify and resolve system issues, perform root-cause analysis, and elevate problems to avoid service disruption
• Ensure benefit plans remain in compliance with all regulatory requirements (federal, CMS, state, local, and pharmacy)
• Develop, maintain, and verify data for drug utilization and claims adjudication systems to support evidence-based benefit coverage decisions
• Support concurrent Drug Utilization Review service messages, table settings, testing and adjudication workflows to ensure accuracy and compliance with established protocols and implementation decisions
• Collaborate with leaders to implement client-requested formulary changes and provide subject- matter expertise to internal and external committees
• Other duties as assigned

Conocimientos

AS400

Lotus Notes

Analytical skills

Team collaboration

Regulatory knowledge

Educación

PharmD or BS Pharmacy

Herramientas

Excel

Word

Claims adjudication system

Descripción del empleo

Prime Therapeutics is seeking a Clinical Pharmacist to deliver clinical and regulatory analysis supporting operations and formulary management, with opportunities to influence benefit plans and compliance. You will partner with internal and client teams to design testing scenarios, perform QA, support drug utilization data, and assist with formulary changes while maintaining regulatory standards.

Eligibility includes PharmD or BS Pharmacy, 1 year of experience, and an active pharmacist license.