Pharmacist - Pharmacy Benefit Management

Oregon Health & Science University; Beaverton (OR); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

Healthcare options

Pension plans

Vacation allowance

Sick leave

8 paid holidays

Transit discounts

Tuition reimbursement

Employee Assistance Program (EAP)

Job summary

OHSU is seeking a PBM Pharmacist to provide clinical support within Pharmacy Benefit Management Services. The role includes formulary management, responding to clinical inquiries, and collaborating on prior authorization processes to optimize drug spend.

The ideal candidate holds a current Oregon pharmacist license and has experience in managed care or PBM settings. Employment is on-site in Beaverton, OR, with comprehensive benefits and opportunities for professional growth.

Qualifications

• Current Pharmacist license issued by the Oregon State Board of Pharmacy.
• Training or experience in a specialized area may be required at time of recruitment.
• Drug therapy knowledge and current medication use systems.
• Strong interpersonal communication and organizational skills.
• Ability to provide drug information through consultations and monographs.
• Experience with PBM or managed care settings is advantageous.

Responsibilities

• Formulary management including adjudication, decision making, and benefit determinations.
• Respond to and resolve clinical inquiries from members, clients, providers, or pharmacies.
• Complete prior authorization requests in collaboration with PBM Technicians.
• Coordinate with pharmacy claims processor to implement formularies and plan designs.
• Develop and present drug monographs, executive summaries, and policy reviews to committees.
• Use claims data to evaluate benefit design and optimize drug spend.

Skills

Interpersonal communication

Organizational skills

Problem solving

Drug information

Pharmacist license

Supervisory concepts

PBM knowledge

Education

Pharmacy degree (B.S. or Pharm.D.)

Residency

Job description

Department Overview

OHSU is Oregon’s only public academic health center. We are a system of hospitals and clinics across Oregon and southwest Washington. We are an institution of higher learning, with schools of medicine, nursing, pharmacy, dentistry and public health – and with a network of campuses and partners throughout Oregon. We are a national research hub, with thousands of scientists developing lifesaving therapies and deeper understanding. We are a statewide economic engine and Portland’s largest employer. And as a public organization, we provide services for the most vulnerable Oregonians, and outreach to improve health in communities across the state.

The PBM Pharmacist provides clinical support to OHSU Pharmacy Benefit Management Services. Support includes but is not limited to formulary management, coverage determinations, Pharmacy and Therapeutics Committee support, responding to clinical inquiries, and implementing clinical programs.

Function/Duties of Position

• Formulary management including but not limited to activities such as adjudication, formulary decision making, and benefit determination.
• Respond to and resolve clinical inquiries from members, clients, providers, or pharmacies related to formulary options, therapeutic alternatives, and coverage determinations.
• Complete prior authorization requests for members through collaboration with PBM Pharmacy Technicians.
• Coordinate with pharmacy claims processor to ensure formularies, clinical edits, and plan designs are implemented according to requirements.
• Assist with developing and presenting drug monographs, executive summaries, therapeutic class reviews, and medication policies to Pharmacy & Therapeutics Committees.
• Utilize claims data to evaluate benefit design for inappropriate utilization and opportunities to improve outcomes and optimize drug spend.

Required Qualifications

• A current Pharmacist’s license issued by the Oregon State Board of Pharmacy.
• OHSU may require training or experience in a specialized area at time of recruitment.

Job Related Knowledge, Skills And Abilities (Competencies)

• Drug therapy knowledge (Dosage, indications, side effects, etc.)
• Contemporary medication use systems
• Drug information through written and verbal consults as well as monographs
• Interpersonal communication
• Excellent organizational skills
• Supervisory concepts (for indirect reports)
• Problem solving

Preferred Qualifications

• B.S. Pharmacy or Pharm.D.
• Pharmacy practice residency or three years equivalent work experience
• 2 years or more in managed care, health plan or pharmacy benefit management setting
• PBM operational experience
• Specialty pharmacy practice
• Pharmacy benefit design
• Pharmacy & Therapeutics Committee participation
• Medication policy development
• Pipeline development
• Project management skills

Additional Details

The PBM pharmacist will experience competing demands and frequent interruptions from PBM Technicians, clients, members, and other health care professionals.

Benefits

• Healthcare Options - Covered 100% for full-time employees and 88% for dependents, and $25K of term life insurance provided at no cost to the employee
• Two separate above market pension plans to choose from
• Vacation- up to 200 hours per year depending on length of service
• Sick Leave- up to 96 hours per year
• 8 paid holidays per year
• Substantial Tri-met and C-Tran discounts
• Additional Programs including: Tuition Reimbursement and Employee Assistance Program (EAP)

Why apply to OHSU?

We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.

All are welcome.

OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply.

To request reasonable accommodation, contact [e-mail]