Job Description

Resp & Qualifications

PURPOSE:
The Clinical Pharmacist will perform comprehensive clinical services with a focus on specialty drug 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.

ESSENTIAL FUNCTIONS:

Develops and executes on strategies to manage specialty drug spend; Tracks productivity, quality, impact, and overall performance of specialty 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 specialty drug subject matter expert; Provides expertise to both internal and external stakeholders regarding specific pharmacy trends and market insights; Provides recommendations to control specialty drug costs.

Develops and provides formal written and verbal presentations or other communication materials related to specialty 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 specialty 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 with a focus on specialty drugs.

QUALIFICATIONS:

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)

• 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.

Licenses/Certifications:
PHARMD - Licensed Pharmacist Active Maryland Registered Pharmacist Upon Hire Required.

Department

Department:

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.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply:

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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