Remote Clinical Formulary Pharmacist — Managed Care

Centene

United States

Remote

USD 108,000 - 199,000

Full time

5 days ago

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Benefits offered by this job

Health insurance

401K and stock purchase plans

tuition reimbursement

paid time off plus holidays

a flexible approach to work withremote

Job summary

Centene is seeking a Pharmacist to define and develop standard and custom formularies across Commercial, Medicaid, Medicare Part D, and the Health Information Marketplace. This fully remote role requires collaboration with Pharmacy & Therapeutics to optimize drug utilization and policy design.

Candidates must hold a PharmD or advanced degree, with 3+ years in managed care pharmacy or residency, and a current pharmacist license.

Qualifications

Bachelor’s degree or PharmD/MS in pharmacy.
3+ years of managed care pharmacy experience or pharmacy residency.

Responsibilities

Develop drug product review and formulary recommendations by assessing drug use trends and new drug releases.
Analyze pharmacy cost of care, trends, and coordinate development of guidelines.
Set criteria for medication analysis and coordinate client reports.
Develop criteria for review of non-formulary or non-preferred drug lists and communicate with clients.
Design clinical edits to adjudicate claims and enhance drug utilization.
Review guideline criteria for prior authorization and non-formulary drugs for P&T Committee support.
Research drug information to maintain knowledge for prior authorization reviews.
Provide clinical guidance to pharmacy technicians.
Prepare documentation for P&T Committee reviews and decisions.