Provider Liasion Pharmacists - Middle TN

Prime Therapeutics; Oregon; Hybrid; USD 108,000 - 184,000; Full time

Job summary

Prime Therapeutics is seeking a Provider Liaison Pharmacist to support clinical and regulatory activities for benefit plans and formulary management. The role focuses on testing, data development for drug utilization, and ensuring compliance with regulatory requirements.

Ideal candidates hold a PharmD or B.S. Pharmacy, with 1 year of relevant experience and an active pharmacist license in the United States.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree.
• Current Pharmacist license to practice in applicable state(s).
• 1 year of work experience in clinical, retail, hospital, or managed care.
• Must be eligible to work in the United States without visa sponsorship.

Responsibilities

• Deliver clinical and regulatory analysis to support operations and program implementation.
• Develop, maintain, and verify data for drug utilization and claims adjudication systems.
• Coordinate with internal stakeholders and clients on testing scenarios and formulary changes.
• Ensure compliance with federal, CMS, state and local regulations and quality assurance standards.
• Support testing, evidence-based benefit coverage decisions, and regulatory requirements.

Skills

Analytical skills

Regulatory compliance

Project management

Stakeholder collaboration

Education

Pharmacist degree (PharmD or B.S. Pharmacy)

Tools

AS400

Lotus Notes

MS Excel

MS Word

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Provider Liasion Pharmacists - Middle TN

Job Description

The Clinical Pharmacist is responsible for delivering clinical and regulatory analysis activities that support operations and the implementation of clinical and regulated programs, including coverage lists for benefit plans, formulary management, and publications. This role participates in internal and client-initiated projects, conducting analysis and ensuring compliance with quality assurance standards. This position provides direct support for benefit plan functions and contributes to the execution of regulatory requirements and pharmacy-related initiatives.

Responsibilities

Partner with internal stakeholders and clients to develop and maintain project and benefit plan testing scenarios, including utilization management and specialty offeringsInterpret project requests to determine feasibility, document requirements, and provide technical solutionsConduct testing, including test plan creation, test execution, and User Acceptance Testing for quality assuranceIdentify and resolve system issues, perform root-cause analysis, and escalation problems to avoid service disruptionEnsure 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 decisionsSupport concurrent Drug Utilization Review service messages, table settings, testing and adjudication workflows to ensure accuracy and compliance with established protocols and implementation decisionsCollaborate with leaders to implement client-requested formulary changes and provide subject-matter expertise to internal and external committeesOther duties as assigned

Minimum 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)
• Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

• Knowledge of AS400, queries, and Lotus Notes
• Strong analytical and problem-solving skills with attention to detail and quality
• Ability to manage multiple projects simultaneously under pressure with strict timelines
• Skilled in developing and improving process efficiencies
• Strong collaboration skills and ability to work in a team-oriented environment
• Proficiency with Microsoft Excel and Word

Preferred Qualifications

• MediSpan or First Databank experience
• Formulary Database/Workplace management tool experience
• Claim adjudication system experience
• Board of Pharmacy Specialties (BPS) certification, pharmacy residency, or fellowship

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job

Potential pay for this position ranges from $108,000.00 - $184,000.00 based on experience and skills.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.