Medicare Part D Pharmacist – Formulary & Cost Management

Doctors HealthCare Plans, Inc.; Coral Gables (FL); In loco; USD 110.000 - 135.000; Tempo pieno

Descrizione del lavoro

Doctors HealthCare Plans, Inc. is seeking a Clinical Pharmacist to oversee Part D coverage determinations and formulary management, coordinating with PBMs and plan stakeholders.

The role includes evaluating prescriber utilization data, identifying cost-saving opportunities, and developing educational materials for providers to promote cost-effective prescribing. Responsibilities also cover CMS compliance, drug reviews for the Pharmacy & Therapeutics Committee, and aligning drug management across

Competenze

• Managed Care experience preferred but not required.
• Part D Coverage Determinations and Formulary Management experience preferred.
• HPMS FRF submission experience preferred but not required.
• Strong computer skills and ability to work with data and reporting tools.
• Florida license as Pharmacist with clinical background.

Mansioni

• Formulary management and FRF submissions in HPMS.
• Develop education material for providers.
• Conduct member medication reviews to identify polypharmacy and inappropriate prescribing.
• Oversee PBM rebate strategy and cost-saving initiatives.
• Participate in Pharmacy & Therapeutics Committee meetings.
• Review CMS model letters and coverage determinations.
• Monitor optimal cost-effective drug management and prior authorizations.
• Provide internal staff education on pharmacy benefit and formulary.

Conoscenze

Managed care experience

Cost-management

Strong communication

Detail-oriented

Formazione

PharmD degree

Florida pharmacist license

Residency PGY1 in managed care pharmacy

RPh with clinical experience

Strumenti

Microsoft Office

Programming or reporting software

Descrizione del lavoro

Doctors HealthCare Plans, Inc. is seeking a Clinical Pharmacist to oversee Part D coverage determinations and formulary management, coordinating with PBMs and plan stakeholders.

The role includes evaluating prescriber utilization data, identifying cost-saving opportunities, and developing educational materials for providers to promote cost-effective prescribing. Responsibilities also cover CMS compliance, drug reviews for the Pharmacy & Therapeutics Committee, and aligning drug management across