Resp & Qualifications
The Clinical Pharmacist will perform comprehensive clinical services with a focus on trend management for drugs covered under the pharmacy and medical benefit. Responsibilities will include but not are limited to; specialty drug management, utilization management, clinical drug evaluations, development of drug management tools, and oversight of delegated programs. This position will work in a matrixed environment across the organization.
Develops and executes on strategies to manage drug spend; Tracks productivity, quality, impact, and overall performance of drug management strategies, clinical pharmacy programs, formularies, and/or utilization management. Identifies areas where program modifications could result in improvements to patient outcomes and reduce costs. Works collaboratively with vendors, PBMs, and internal parties for oversight of programs and performance management.
Acts as a drug subject matter expert; Provides expertise to both internal and external stakeholders regarding specific pharmacy trends and market insights; Provides recommendations to control drug costs.
Develops and provides formal written and verbal presentations or other communication materials related to drug management, clinical pharmacy programs, pharmacy utilization, pharmacy strategy, and pharmacy topics to a broad audience including both internal and external stakeholders.
Assesses value of drug management strategies, clinical pharmacy programs and strategies through clinical outcomes, usage, quality, and financial metrics to assist in meeting strategic plan goals. Ensures pharmacy programs are compliant with regulatory mandates. Participates in the development and execution of initiatives to improve quality measures.
Reviews pharmacy market information and trends to develop and coordinate the implementation of appropriate strategies or programs for cost containment and clinical management.
Education Level: Medical Degree in Pharmacy (Doctorate of Pharmacy).
Experience: 5 years experience in clinical pharmacy, preferably in a managed care environment.
Preferred Qualifications: Experience working in healthcare industry with a thorough understanding of prescription benefit management programs and practices.
Knowledge, Skills and Abilities (KSAs)
PHARMD - Licensed Pharmacist Active Maryland Registered Pharmacist Upon Hire Required.
Salary Range: $111,920 - $200,057
Salary Range Disclaimer
Salary will be based on education, location, experience, certifications, etc. In addition to your salary, CareFirst offers benefits such as a comprehensive benefits package, incentive and recognition programs, and 401k contribution (all benefits are subject to eligibility requirements).
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship.
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