Note: The job is a remote job and is open to candidates in USA. MedImpact Healthcare Systems, Inc. is seeking a Clinical Administrative Pharmacist to optimize drug therapy quality and cost-effectiveness for a state Medicaid agency. The role involves managing clinical projects, providing consultative services, and ensuring compliance with service level agreements while collaborating with internal and external clients.
Responsibilities
- Provides Support for the state client PA process, Appeals, Pharmacy Lock-In process, and assistance with Pharmacy Audit process
- Monitors contractual Service Level Agreements (SLAs) related to clinical services for managed account(s) and reports to leadership if risks are observed
- Provides recommendations to assigned clients that align with the clients' goals of achieving lower net costs and high clinical quality. Strategic recommendations may include benefit design and Preferred Drug List (PDL) analysis and suggestions, provision of clinical drug information, utilization management criteria development, Pharmacy & Therapeutics (P&T) support and participation, recommendations for rational drug PDL positioning, online system edits and restrictions, ongoing clinical product evaluations, and recommendations regarding client pharmacy benefit utilization and performance trends
- Offers clinical and Medicaid consultative services in accordance with contracted services. Acts as an integral part of designing, developing, and driving the clinical components of the assigned account team's strategic and financial goals. The CAE II focuses on using a variety of analytical tools and clinical resources to identify opportunities that simultaneously improve the plan sponsor's quality-focused and financial performance metrics
- Identifies and promotes MedImpact's evidence-based interventions and communication programs to clients, providing documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g., rebate enhancement, lower net cost, generic programs, QA programs)
- Recommends clinically appropriate PDL changes, considering the lowest net cost after rebates, market shifts, and utilization
- Coordinates clinical utilization analyses and presentations to clients, ensuring timely and accurate review of plan data according to policy and offering appropriate intervention recommendations
- Coordinates the clinical support of Preferred Drug Lists during plan sponsor implementation
- Participates in quarterly state P&T meetings as stipulated by client contracts
Skills
- PharmD and 5+ years' experience or equivalent combination of education and experience, and 3 years' of SME in respective areas
- Must hold current Tennessee Board of Pharmacy licensure or complete license reciprocity prior to contract go-live date
- Knowledge of Microsoft Office Suite and experience with at least one business intelligent tool (IBM Cognos or Tableau preferred)
- Registered Pharmacist license in good standing and the ability to obtain licensure in specific state as necessary within 6 months
- Familiar with First Databank and Medi-Span drug information
- Analytical skills required to perform drug cost expenditure impact analysis
- Exceptional communication skills and interpersonal skills to interface with clients and internal team members
- Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions
- Ability to deal with problems involving a few concrete variables in standardized situations
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
- Candidates must have an understanding of pharmaceutical calculations including fractions, decimals, ratios, proportions, percentages, and medication dosing
- Ability to write routine reports and correspondence
- Ability to speak effectively before groups of customers or employees of organization
- Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community
- Experience with IBM Cognos or Tableau
Benefits
- Medical / Dental / Vision / Wellness Programs
- Paid Time Off / Company Paid Holidays
- Incentive Compensation
- 401K with Company match
- Life and Disability Insurance
- Tuition Reimbursement
- Employee Referral Bonus
Company Overview
MedImpact is the nation’s largest independent health solutions and pharmacy benefit company, serving commercial health plans, government programs, self insured/employer groups, and millions of consumers. It was founded in 1989, and is headquartered in San Diego, California, USA, with a workforce of 1001-5000 employees. Its website is http://medimpact.com.