Member-Centric Clinical Pharmacist & Care Concierge

OpenKrill; United States; Remote; USD 120,000 - 125,000; Full time

Job summary

Rightway is seeking a Clinical Pharmacist, Care Team, to join its PBM Clinical Operations. The role emphasizes a pharmacist-in-the-family approach, engaging members by phone, chat, and email with compassionate, high-touch service.

You will perform drug utilization reviews, comprehensive medication reviews, and collaborate with providers to close therapy gaps, while ensuring formulary compliance and regulatory standards. Travel may be occasional.

Qualifications

• Pharmacy degree required; PharmD preferred.
• 3 years in direct patient care such as PBM clinical operations or Health Plan Pharmacy.
• Pharmacy License: state licensure required; multi-state licenses preferred.

Responsibilities

• Guide members as if you are the “Pharmacist in the Family” to help members manage their medications and disease states
• Engage with members via phone, chat, and email to provide a white glove/concierge experience for members
• Go above and beyond to answer member questions about all things pharmacy related
• Perform core Pharmacist duties including prospective/retrospective drug utilization reviews, comprehensive medication reviews, and recommending changes to patient's drug regimens
• Partners with Rightway’s Navigation team where needed to provide holistic support to members
• Engages with providers to address medication gaps in therapy for patients, drug therapy recommendations, formulary compliance, and serve as a subject matter expert on medications
• Contributes to the Pharmacy & Therapeutics committee in the research, preparation and presentation of drug monographs, therapeutic category reviews and clinical policy development. Ensures that these processes meet or exceed regulatory and best practice standards
• Supports prior authorization review process as needed regarding drug product selection and formulary compliance to ensure quality of care
• Perform utilization management reviews and support outreach to members and providers to drive clinical and cost-savings outcomes.
• Effectively collaborate with third-parties in the administration of Rightway’s clinical pharmacy strategy
• Responsible for achieving productivity and quality of work metrics for clinical pharmacy interactions
• Contribute to the design and evolution of technology-enabled processes to create a scalable clinical pharmacy operation
• Ensures regulatory standards are consistently met

Skills

Empathy

Communication

Problem-solving

Attention to detail

Project leadership

Phone/chat support

Education

Doctor of Pharmacy (PharmD)

Licensed pharmacist in US

Job description

Rightway is seeking a Clinical Pharmacist, Care Team, to join its PBM Clinical Operations. The role emphasizes a pharmacist-in-the-family approach, engaging members by phone, chat, and email with compassionate, high-touch service.

You will perform drug utilization reviews, comprehensive medication reviews, and collaborate with providers to close therapy gaps, while ensuring formulary compliance and regulatory standards. Travel may be occasional.