Pharmacist Consultant (Pharmacy Benefit Management Subject Matter Expert)

Myers & Stauffer; Baltimore (MD); On-site; USD 110,000 - 160,000; Full time

Benefits offered by this job

Health, Dental, Vision insurance

Vacation and sick time

Paid holidays

401K with company matching

Tuition reimbursement and referralBonu

Mentor program and career development

Employee assistance program

Job summary

Myers and Stauffer LC in Baltimore, MD invites a Pharmacist Consultant to join our government PBM audit and consulting team, focusing on pricing adherence, formulary management, rebates and performance guarantees.

You will analyze claims data, perform audits, prepare client reports, participate in meetings, and collaborate across teams while upholding strict PHI security and professional confidentiality across engagements.

Qualifications

• Pharmacy degree from ACPE-accredited school.
• Active pharmacy license in any state.
• 6+ years of relevant work experience.
• Minimum of 3 years of PBM or prescription benefits management experience.
• Well organized with accuracy and attention to detail.
• Strong analytical and problem solving skills; SQL a plus.
• Excellent verbal and written communication; able to interact with all levels.
• Ability to travel overnight occasionally to client sites.

Responsibilities

• Perform pharmacy benefit related performance audits of government clients and health plans.
• Participate in client meetings to obtain key benefit facts and documentation for audits.
• Collaborate in a team-based environment to perform audits using analytical processes and claims data validation techniques.
• Examine and validate initial analysis output.
• Communicate and engage with the audited PBM to review findings and assess variances.
• Prepare and review reports and workbooks of audit outcomes for clients.
• Maintain security and confidentiality of PHI encountered during audits.
• Participate in meetings and team projects with clients.
• Collaborate with staff and communicate effectively.
• Additional responsibilities as assigned.

Skills

Analytical skills

Communication skills

Multi-tasking

SQL knowledge

Team collaboration

Education

Pharmacy degree ACPE-accredited

Active pharmacy license (any state)

High school diploma or GED

Tools

Microsoft Word

Excel

PowerPoint

Job description

Job Description

The Pharmacist Consultant works in a team environment on government client pharmacy benefit manager (PBM) audits and audit related consulting engagements to validate the integrity and accuracy of the administration of pharmacy benefit programs. This includes all aspects of contracted services including pricing adherence, formulary management, performance guarantees, rebate administration, and operational functions of the PBM.

Essential Functions And Primary Duties

• Perform pharmacy benefit related performance audits of government clients and health plans
• Participate in client meetings to obtain key benefit facts and documentation for the audits
• Collaborate in a team-based environment to perform the audits using a variety of analytical processes and claims data validation techniques
• Examine and validate initial analysis output
• Communicate and engage with the audited PBM to jointly review initial findings and assess any variances or discrepancies
• Prepare and review reports and workbooks of the audit outcome for clients
• Maintain security and confidentiality of all protected health information encountered during performance and other essential functions
• Participate in meetings, team projects, and discuss current topics with clients
• Collaborate with staff and listen and communicate effectively
• Additional responsibilities as assigned

Preferred Qualifications

• Pharmacy degree from ACPE – accredited pharmacy school
• Must have and preserve an active pharmacy license (any state)
• 6 + years of relevant work experience
• Minimum of 3 years of pharmacy managed care or prescription benefits management (PBM) experience required
• Well organized with a high degree of accuracy and attention to detail
• Strong analytical and problem solving skills, working knowledge of SQL a plus
• Demonstrated ability to communicate verbally and in writing with all levels of the organization, both internally and externally
• Effective in multi-tasking with planning and efficiency
• Proficient use of applicable software programs, including Microsoft Word, Excel, and PowerPoint
• Ability to function within a team environment as well as work independently
• Self-motivated with a strong work ethic
• Ability to travel overnight occasionally to client sites and regional offices

Minimum Qualifications

• High school diploma or GED

About Us

Myers and Stauffer LC is a certified public accounting and health and human services consulting firm, specializing in audit, accounting, data management and consulting services to government-sponsored health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45+ years of experience assisting our government clients with complex health care reimbursement and provider compliance issues, operate 21 offices and have over 900 associates nationwide.

At Myers and Stauffer, you will have a career that is rewarding while also supporting our state and federal government health and human service clients that focus on those in need. We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team. Our firm takes pride in the welcoming and collaborative culture we have throughout our offices. We are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing.

What We Offer

• Health, Dental, and Vision insurance along with other competitive employee benefits for eligible associates
• Vacation time, sick time, and paid holidays
• Paid Parental Leave and available support resources
• 401K with company matching for eligible employees
• Tuition reimbursement, referral bonuses, paid volunteer community service time, mentor program, and a variety of other employee programs and perks
• A combination of technical and leadership development training at each career milestone
• Up to six counseling sessions per year for eligible employees through our Employee Assistance Program