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Clinical Pharmacist
2 months ago
As a Clinical Pharmacist at Wellmark, you will play a crucial role in developing and implementing clinical pharmacy programs to promote quality and cost-effective drug use. You will provide clinical consulting services to internal and external stakeholders, as well as provide clinical information and education.
Key Responsibilities- Develop and implement clinical pharmacy programs to promote quality and cost-effective drug use.
- Provide clinical consulting services to internal and external stakeholders.
- Provide clinical information and education.
- Support medical management and clinical pharmacy initiatives of Wellmark in support of commercial and exchange lines of business.
- Research and synthesize detailed clinical data related to medications and drug therapies.
- Develop evidence-based clinical programs for both pharmacy and medical benefits.
- Develop and coordinate appropriate drug therapy interventions that demonstrate quality improvement, reduction in the cost of care, and improved outcomes.
- Actively identify and make recommendations regarding ideas to improve the quality effectiveness and efficiency of pharmacy services offered by the health plan.
- Make recommendations to improve medication regimens as appropriate.
- Direct and support internal ad hoc pharmacy management projects, as well as projects with the contracted pharmacy benefit manager, as needed.
- Evaluate, prepare, and present therapeutic class reviews, drug monograph information, and recommendations to the Wellmark Pharmacy and Therapeutics (P&T) Committee and Formulary Assessment Committee.
- Evaluate cost effectiveness, rebate proposals and distribution channels and make recommendations to the Formulary Assessment Committee for formulary additions or changes that support Wellmark's goal of providing access to the most comprehensive and cost-effective formulary options.
- Perform clinical review of medication appeal requests.
- Serve as a clinical resource to other physicians, nurses, and other internal stakeholders on areas such as prospective, concurrent, and retrospective DURs, drug-related fraud, waste, and abuse cases, and provide clinical support for therapeutic interventions.
- In partnership with Marketing and Communications Team, prepare and communicate information to network providers.
- Comply with regulatory standards, accreditation standards and internal guidelines, remain current and consistent with the standard pertinent to pharmaceuticals.
- Bachelor's Degree in Pharmacy OR PharmD.
- An active and unrestricted Pharmacy license in Iowa or South Dakota (individual must be licensed in the state in which they reside) is required within 6 months from date of hire.
- 3+ years of managed care pharmacy or pharmacy residency program experience.
- Broad understanding of the health care delivery system, managed care and pharmacy benefit management systems, plan design and overall operations.
- Ability to make effective evidence-based decisions.
- Strong analytical, problem-solving, and critical thinking skills.
- Excellent written and verbal communication skills.
- Ability to effectively articulate complex information across all levels of an organization.
- Strong consulting and interpersonal skills to quickly build rapport, credibility, and collaborative partnerships with clinical peers, leaders, and stakeholders.
- Proficient in Microsoft Office & intermediate Excel skills - e.g., pivot tables, trend analysis, formulas.
- Strong knowledge of applicable rules, regulations, and guidelines, and maintain awareness of implications to pharmacy.
- Strong organization and prioritization skills.
- Ability to manage multiple projects simultaneously and consistently meet deadlines.
- Self-starter who can work well independently and as a member of a cross-functional team.
- Proven ability to work collaboratively with others.
