Regulatory Clinical Pharmacist - Oversight & Audits

Medica; Madison (WI); On-site; USD 113,000 - 194,000; Full time

Job summary

Medica is a nonprofit health plan serving members across several states. The Clinical Pharmacist - Regulatory role supports Pharmacy oversight for state and federal requirements, compliance audits, and delegated clinical activities to ensure regulatory alignment.

This on-site Madison, WI position offers a salary range of about $113,400 to $170,100 plus incentive potential. Requires PharmD or BS in Pharmacy, active pharmacist license, and 5+ years in health-plan pharmacy or related leadership.

Qualifications

• Pharmacist license is required.
• 5+ years of experience in health plan pharmacy or related leadership role.

Responsibilities

• Review regulatory guidance and interpret its applicability to Medica pharmacy processes.
• Support regulatory audits and compliance inquiries; coordinate corrective action plans.
• Assist with regulatory submissions for all regulators.
• Provide clinical pharmacy support for NCQA initiatives and audits.
• Develop and maintain Policies and Procedures related to pharmacy regulatory processes.
• Oversee clinical review activities delegated to PBM and medical drug vendor.
• Assist with audits and other regulatory activities affecting pharmacy delegates.
• Oversee monitoring and reporting to ensure compliance with regulatory requirements.

Skills

Regulatory oversight

Clinical review coordination

Audit & compliance awareness

Stakeholder collaboration

Education

Bachelor of Science in Pharmacy

PharmD

Job description

Medica is a nonprofit health plan serving members across several states. The Clinical Pharmacist - Regulatory role supports Pharmacy oversight for state and federal requirements, compliance audits, and delegated clinical activities to ensure regulatory alignment.

This on-site Madison, WI position offers a salary range of about $113,400 to $170,100 plus incentive potential. Requires PharmD or BS in Pharmacy, active pharmacist license, and 5+ years in health-plan pharmacy or related leadership.