Clinical Pharmacist
- Hiring from
- United States
- Work type
- Hybrid
- Posted
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- Clinical Program Support
- Support implementation and ongoing management of formulary, utilization management, and clinical policy programs within an assigned line of business.
- Evaluate clinical implications of pharmacy program changes and emerging utilization trends.
- Maintain alignment between clinical strategy and line-of-business needs.
- Identify and communicate opportunities to improve clinical and financial outcomes.
- Formulary & Utilization Management Activities
- Conduct clinical reviews of medications, therapeutic classes, and utilization patterns.
- Formulary evaluations and clinical recommendation development.
- Evaluate utilization management programs and identify opportunities for refinement.
- Development, implementation, and maintenance of clinical policies and coverage criteria.
- Clinical Evaluation & Trend Management
- Review pharmacy utilization data, emerging trends, and clinical outcomes to identify opportunities for intervention.
- Evaluate the clinical impact of new therapies, utilization patterns, and pharmacy initiatives.
- Development of recommendations designed to improve member outcomes and manage pharmacy trend.
- Collaborate with Data Analysts to interpret findings and evaluate potential opportunities.
- Operational & Cross-Functional Collaboration
- Partner with Pharmacy Operations to support operational implementation of clinical decisions and policy updates.
- Collaborate with Pharmacy Solutions on strategic initiatives and readiness planning.
- Support Pharmacy Performance with clinical interpretation of PBM programs, formulary changes, and utilization management performance.
- Serve as a clinical resource for internal stakeholders and external vendor partners.
- Governance & Clinical Consultation
- Support preparation of materials and recommendations for Pharmacy & Therapeutics (P&T) Committee activities.
- Provide clinical consultation regarding formulary, utilization management, and pharmacy program questions.
- Participate in cross-functional initiatives requiring pharmacy clinical expertise.
- Assist with regulatory, accreditation, and compliance activities impacting pharmacy clinical programs.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
- Pharmacy degree and two years of experience as a pharmacist; or equivalent combination of education and experience
- Knowledge of health care industry trends.
- Knowledge of basic relevant statistical analyses.
- Proficiency in issues identification and data collection, analysis, and interpretation.
- Proficiency in development and execution of operational process flows.
- Strong oral and written communication skills.
- Intermediate working knowledge of Microsoft Office applications. Including but not limited to Word, Excel, PowerPoint, and Outlook.
- Hawaii Pharmacist licensure.
