Remote Hca Utilization Review Jobs in Missouri (NOW HIRING)

Archimedes
Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit alignment, value and transparency Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. .____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.
USD $0.00 - USD $0.00 /Yr.
5.00 - Salaried Non-Management except pharmacists
M-F 8am-5pm
ATTENTION: Archimedes is unable to offer remote work to residents of Alaska, Arizona, Arkansas, California, Connecticut, Delaware, Hawaii, Idaho, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Montana, Nebraska, Nevada, New Mexico, New York, North Carolina, North Dakota, Oregon, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Washington, West Virginia, And Wyoming.

Archimedes is a specialty drug management company with industry-leading technology and services that health plans and employer groups can use to manage specialty drug spend. We are expanding our team and looking for a clinical professional who has specialty drug management experience and a passion for cost management. Given our continued growth trajectory, we are looking for a person who can grow with the company.

The Clinical Account Executive (RPh) is responsible for being the clinical expert for all specialty medications across both the pharmacy and the medical benefit. This role will communicate with clients, brokers, consultants, prospects, physicians, nurses, pharmacists, and members related to specialty drugs management.

The Clinical Account Executive (RPh) will be the clinical subject matter expert for formulary and utilization management development and decision making. This role will be divided into two areas: formulary development across pharmacy and medical benefits for specialty drugs and clinical management of accounts.

How do I make an impact on my team?   

• Develop and deliver clinical messages to physicians, members, clients, and consultants.
• Manage formulary strategy and clinical policy development.
• Clinical program development including both medical and pharmacy benefit management .
• Define, document, and deliver results for plan sponsors.
• Evaluate and summarize clinical literature as well as financial implications related to medication management options.
• Complete clinical prior authorizations and retrospective reviews.
• Present deep clinical and cost effectiveness information as a peer-to-peer consult.
• Participate in, adhere to, and support compliance, people and culture, and learning programs.
• Perform other duties as assigned.

What our team expects from you?

• Education: Graduate of ACPE Accreditation School of Pharmacy with a B.S. Pharmacy or PharmD degree required.

• Certification/Licenses: Current, unrestricted licensure as a Registered Pharmacist in the state of residence, or the ability to gain reciprocity within 4 months, may be required based on state of residence laws or client contracts. Refer to the Licensure and Credentialing Verification P&P for current detail.
  • Board of Pharmacy Certification preferred for Pharmacotherapy, Ambulatory Care, or Oncology Care.

• Experience:
  o    Pharmacy and Medical specialty benefit knowledge and clinical account management experience required.
  o    Former P&T Committee experience or formulary development experience required.
  o    3-5 years clinical or managed care experience or Clinical/Managed Care Pharmacy Residency required.
  o    Microsoft Excel, Power Point and Word proficiency required.

502 Earth City Expy STE 300
Earth City
MO
63045