Clinical Policy & PA Advisor

nirvanaHealth | RxAdvance; Southborough (MA); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Competitive benefits

Focus on employee wellness

Support for employee growth

Job summary

A healthcare technology company is seeking a Clinical Advisor to enhance pharmacy benefit operations. This role involves expertise in drug formularies, clinical reviews, and coordination with pharmacy professionals. Candidates should hold a Bachelor's in Pharmacy or a PharmD and possess strong knowledge of pharmacy regulations. The position offers an opportunity to work on innovative solutions in healthcare and contribute to managing operational efficiency within a collaborative team environment.

Qualifications

• Expertise in drug-related prior authorization requirements.
• Knowledge of state and federal pharmacy regulations.
• Experience in managing drug formularies and clinical programs.

Responsibilities

• Serve as a subject matter expert in drug formularies.
• Collaborate with pharmacy technicians and pharmacists.
• Conduct clinical reviews of PA and related requests.
• Assist in developing clinical utilization criteria.
• Support pharmacy benefit performance and trends.

Skills

Pharmacy expertise

Clinical knowledge

Analytical skills

Communication skills

Education

Bachelor’s degree in pharmacy or related fields

Doctor of Pharmacy (PharmD)

Managed Care or Clinical Residency

Tools

Micromedex

Lexicomp

Clinical Pharmacology

Job description

A healthcare technology company is seeking a Clinical Advisor to enhance pharmacy benefit operations. This role involves expertise in drug formularies, clinical reviews, and coordination with pharmacy professionals. Candidates should hold a Bachelor's in Pharmacy or a PharmD and possess strong knowledge of pharmacy regulations. The position offers an opportunity to work on innovative solutions in healthcare and contribute to managing operational efficiency within a collaborative team environment.