Clinical Pharmacist - Care Team
Core
Guide members to manage medications and disease states via phone, chat, and email while performing clinical pharmacy duties like drug utilization reviews and medication therapy management.
Role type
Senior clinical pharmacist (PBM operations)
Builds
Member engagement workflows, medication therapy management services, and clinical policy recommendations
Domain
Healthcare / Pharmacy Benefit Management (PBM)
Required skills
Medication therapy management, drug utilization review, formulary compliance, prospective/retrospective reviews, provider engagement, clinical policy development, utilization management, regulatory standards adherence, multi-state licensure
Preferred skills
Managed care experience, pharmacy residency, multi-state licenses, technology-enabled process design
Technologies
Rightway app, chat function, email, phone systems
Responsibilities
Engage members via phone, chat, and email to provide concierge medication support; Perform drug utilization reviews and recommend regimen changes; Partner with navigation teams to address medication gaps; Contribute to Pharmacy & Therapeutics committee for policy development; Support prior authorization and utilization management reviews; Collaborate with third parties on clinical strategy; Achieve productivity and quality metrics.
Seniority
Senior, hands-on IC