Formulary Pharmacist - Remote
Pharmpix Guaynabo, PR
- Expired: over a month ago. Applications are no longer accepted.
This is your chance to unleash your full potential!
PharmPix, is currently seeking for qualified Formulary Pharmacist candidate to join our team. We are looking for successful people like you. Join the fastest growing Pharmacy Benefit Management (PBM) company in its category and take your professional career to the next level. PharmPix has become a leading provider of pharmacy benefit solutions and services in the continental United States and the territories.
Our work philosophy is based on commitment, dedication and loyalty. We take care of our employees, just as we ensure the welfare of our clients and partners. If you are creative, service oriented, resourceful and visionary, we would like to hear from you.
The Formulary Pharmacist reports to the Formulary Manager. The Formulary Pharmacist defines and develops standard and custom formularies for all lines of business including but not limited to Commercial, Medicaid, Medicare Part D, and the Health Information Marketplace.
Essential Roles and Responsibilities
- Interpret and apply state and federal regulations related to pharmacy claims processing for formulary development and compliance.
- Continually review to detect medication utilization issues related to formulary and drug plan design. Provide analysis via data warehouse query or available report evaluation. Communicate data-based explanations to clients for trends and explore opportunities for improvement as necessary.
- Assist with the development of formulary-specific documentation of maintenance activities to clients and regulatory bodies.
- Prepare formulary submission setups and updates – includes evaluating drugs for tiering based on cost, clinical classification, quality checking, troubleshooting client issues with submissions, and provision of member documents. This includes all aspects of the formulary utilization management program (Prior Authorization, Step Therapy, Quantity Limit, Drug Utilization Review (DUR)—concurrent, prospective, or retrospective, etc.).
- Provide business-enhancement proposals, contribute to requirement specifications, and perform user acceptance testing on enhancements to formulary management tools and other formulary projects.
- Provide subject matter expertise and support for internal and external clients. Support internal departments with clinical and analytical requests concerning formulary (e.g. Requests for Proposal, Sales and Marketing, Client Services).
- Maintain policy and procedures and work instructions.
- Conducts annual review of Formulary unit standards, such as quantity limit and step therapy protocols.
- Coordinate and assist in the preparation of utilization and compliance reporting for client plans. Ensures timely preparation and review of plan data and client presentations, when required.
- Contribute to formulary policy development utilizing evidence-based practices to make pharmaceutical recommendations based upon clinical found in labeling, drug compendia, and peer-reviewed clinical literature about the use of the drugs.
- Responsible for the development and implementation of an overall formulary quality assurance program. Ensure benchmarks for quality and accuracy are met in maintaining and updating client formularies.
- Perform cost-benefit analyses of certain drugs, drug classes, and utilization trends.
Professional Experience and Skills Requirements:
- B.S. in Pharmacy or PharmD. or equivalent combination of education and experience.
- Two (2) to five (5) plus years related experience and/or training in formulary management or similarly related duties (preferred).
- Completion of a Residency in Managed Care desired.
- Academy of Managed Care Pharmacy (AMCP) Managed Care Certification or certification within the first six months of employment.
- Current, valid, and unrestricted state or local pharmacist license.
- Active membership in a state or local pharmacy association.
- Fully bilingual: Spanish and English.
- Strong analytical skills.
- Knowledge of Microsoft Access, Word, Excel, PowerPoint, and Outlook, as well as Internet Explorer Good oral and written communication skills.
- Comprehension of Medicare Part D rules and regulations.
- Skill in exercising a high degree of initiative, judgment, discretion, and decision-making to achieve organizational objectives.
- Skill in exercising judgment in applying, interpreting, and coordinating departmental policies and procedures.
The candidate must have:
- 100% of the Covid-19 Vaccine.
- Internet Accessibility with or more 10MB speed.
- Must be able to work hybrid (on site and remote)
PharmPix is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans
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