Resp & Qualifications
This position is listed as HYBRID; therefore, we prefer to have candidates that live in the MD, DC, VA, PA, DE, etc. locations in order to travel into the offices a several times/month or more often as needed.
PURPOSE:
The Clinical Pharmacist Specialty Drug Strategy will perform comprehensive clinical services with a focus on specialty drug strategy development across medical and pharmacy benefits. Strategic areas will include, but are not limited to, coverage policy development, drug pricing and reimbursement, and rebate program management. This position will work in a matrixed environment across the organization.
ESSENTIAL FUNCTIONS:
- Reviews rebate opportunities and makes recommendations for their implementation to optimize cost savings.
- Develops policies to support drug management strategies and engages with oversight committees to ensure alignment and compliance.
- Analyzes pharmacy market trends to develop and implement strategies for cost containment and clinical management, with a focus on specialty drugs.
- Collaborates with vendors and cross-functional teams to identify opportunities for optimal benefit design alignment with market trends.
- Serves as a subject matter expert on specialty drugs, providing insights and recommendations to internal and external stakeholders on pharmacy trends and cost control measures.
- Creates and delivers presentations and other communication materials on specialty drug management, pharmacy strategy, and related topics to a diverse audience.
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:
- Experience working in healthcare industry with a thorough understanding of specialty drug management across pharmacy and medical benefits across multiple lines of business (Commercial, Medicare, Medicaid), with a focus on drug pricing, reimbursement, and market trends. Certified Specialty Pharmacist (CSP) credential 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.
Salary Range: $120,160 - $214,786 (salaries are based on education, 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
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
#LI-CN1