Pharmacist Provider Liaison & Formulary Specialist

Prime Therapeutics; Topeka (KS); On-site; USD 108,000 - 184,000; Full time

Job summary

Prime Therapeutics is seeking a Provider Liaison Pharmacist to support clinical and regulatory analysis for benefit plans and formulary management. The role involves collaboration with internal stakeholders and clients to ensure compliance and data integrity for drug utilization and claims adjudication.

Responsibilities include testing, requirement documentation, and supporting regulatory initiatives with opportunities to influence formulary changes and client projects.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree.
• 1 year of work experience in clinical, retail, hospital, or managed care.
• Current Pharmacist license to practice in the applicable state(s).

Responsibilities

• Partner with internal stakeholders and clients to develop and maintain project and benefit plan testing scenarios, including utilization management and specialty offerings
• Interpret project requests to determine feasibility, document requirements, and provide technical solutions
• Conduct testing, including test plan creation, test execution, and User Acceptance Testing for quality assurance
• Identify and resolve system issues, perform root-cause analysis, and elevate problems to avoid service disruption
• Ensure benefit plans remain in compliance with all regulatory requirements (federal, CMS, state, local, and pharmacy)
• Develop, maintain, and verify data for drug utilization and claims adjudication systems to support evidence-based benefit coverage decisions
• Support concurrent Drug Utilization Review service messages, table settings, testing and adjudication workflows to ensure accuracy and compliance with established protocols and implementation decisions
• Collaborate with leaders to implement client-requested formulary changes and provide subject- matter expertise to internal and external committees
• Other duties as assigned

Skills

Analytical thinking

Education

Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree

Tools

AS400

Lotus Notes

Excel

Word

Job description

Prime Therapeutics is seeking a Provider Liaison Pharmacist to support clinical and regulatory analysis for benefit plans and formulary management. The role involves collaboration with internal stakeholders and clients to ensure compliance and data integrity for drug utilization and claims adjudication.

Responsibilities include testing, requirement documentation, and supporting regulatory initiatives with opportunities to influence formulary changes and client projects.