Provider Liaison Pharmacists — Formulary & Compliance Lead

Prime Therapeutics; Columbus (OH); Vor Ort; USD 108.000 - 184.000; Vollzeit

Zusammenfassung

Prime Therapeutics in the United States seeks a Clinical Pharmacist to deliver clinical and regulatory analysis supporting operations, benefit plan testing, formulary management, and compliance with quality standards. The role engages in internal and client projects and contributes to pharmacy‑related initiatives.

You will interpret requirements, develop testing scenarios, perform testing and UAT, and collaborate to implement formulary changes while ensuring adherence to federal, CMS, state, and

Qualifikationen

• Doctor of Pharmacy or PharmD/BS required; 1 year of relevant work experience.
• Current pharmacist license to practice in applicable state(s).
• Must be eligible to work in the United States without visa sponsorship.

Aufgaben

• 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.

Kenntnisse

Clinical pharmacy

Analytical skills

Regulatory knowledge

Communication

Ausbildung

PharmD or BS in Pharmacy

Tools

AS400

Lotus Notes

MediSpan

First Databank

Excel

Word

Formulary database tools

Jobbeschreibung

Prime Therapeutics in the United States seeks a Clinical Pharmacist to deliver clinical and regulatory analysis supporting operations, benefit plan testing, formulary management, and compliance with quality standards. The role engages in internal and client projects and contributes to pharmacy‑related initiatives.

You will interpret requirements, develop testing scenarios, perform testing and UAT, and collaborate to implement formulary changes while ensuring adherence to federal, CMS, state, and