Jobs for People with MS: National MS Society

Resp & Qualifications

Candidates are preferred to live in the MD, DC, VA area in order to travel into the offices several times per month (or more frequently at times). Also, after hours meeting and/or in-person attendance at provider offices is also required.

PURPOSE:

The Clinical Pharmacist will perform comprehensive clinical services with a focus on access and affordability for our commercial benefit. Responsibilities will include but are not limited to clinical consultative support to nurse care managers, population health consultants, and value-based care partners and prescribers; support oversight of utilization management and delegated clinical programs. The Clinical Pharmacist may also perform patient education, medication counseling, drug therapy monitoring, and chronic disease state management for members in clinical programs. This position will work in a matrixed environment across the organization.

ESSENTIAL FUNCTIONS:

• Provide clinical consultative support to internal nurse care managers and external prescribers with a focus on affordable and accessible medication options for members consistent with clinical practice guidelines and our formulary design. For value-based programs, analyze raw pharmacy data for insights and inform pharmacy strategy, and provide pharmacy education and cost transparency to support affordability.

• Supports development and execution of strategies to manage pharmacy and medical benefit drug spend for the commercial line of business. 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, Pharmacy Benefit Managers (PBMs), and internal parties for oversight of programs and performance management.

• Develops and provides formal written and verbal presentations or other communication materials related to value-based care strategies, clinical pharmacy programs, pharmacy utilization, pharmacy strategy, and clinical pharmacy topics to a broad audience including both internal and external stakeholders.

• Reviews pharmacy market information and trends to develop and coordinate the implementation of appropriate strategies or programs for cost containment and clinical management.

QUALIFICATIONS:

Education Level: PharmD in Pharmacy (Doctorate of Pharmacy).

Licenses/Certifications Upon Hire Required:

• PHARMD - Licensed Pharmacist Active in any state and/or DC Registered Pharmacist.

Experience: 5 years experience in clinical pharmacy, preferably in a managed care environment.

Preferred Qualifications:

• Direct patient care experience / ambulatory care strongly preferred. Thorough understanding of pharmacy benefit management programs and practices or managed care experience preferred. Formal post-graduate residency training and/or board certification strongly preferred.

Knowledge, Skills and Abilities (KSAs)

• Ability to work independently, as well as a member of a team.

• Strong critical reasoning skills in clinical decision-making, planning and organizing.

• Current knowledge of clinical practices and related information systems and computer applications, required.

• A strong balance between clinical expertise and business acumen.

• Strong interpersonal, written and verbal communication skills, including presentation skills.

• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $115,280 - $206,063 (salaries are based on education, years of experience & internal equity).

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Pharmacy Management

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.

PHYSICAL DEMANDS:

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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REQNUMBER: 20769