Clinical Formulary Pharmacist

This is a fully remote position, open to applicants in Florida, +1 more state.

📋 Description

• Establish and create both standard and tailored formularies for Commercial, Medicaid, Medicare Part D, and Health Information Marketplace sectors.

• Generate evaluations of drug products and formulary suggestions by analyzing drug usage patterns, newly released medications, and key literature.

• Examine pharmacy care costs and trends, while coordinating appropriate usage protocols and guidelines.

• Determine medication analysis criteria and coordinate client reporting.

• Fulfill regulatory obligations for drug utilization reviews and reporting on fraud and abuse.

• Formulate clinical criteria for non-formulary or non-preferred medications and relay recommendations to clients.

• Create and design clinical edits to adjudicate claims and improve drug utilization.

• Develop and assess prior authorization and non-formulary drug guideline criteria to support the functions of Pharmacy and Therapeutics Committee and pharmacy benefit design.

• Investigate drug information for prior authorization assessments and to enhance understanding of disease states.

• Offer clinical guidance and assistance to assigned pharmacy technicians.

• Provide supporting documentation and communication for Pharmacy & Therapeutics Committee evaluations and decisions.

• Execute additional duties as needed.

• Adhere to all policies and standards.

⛳️ Requirements

• Bachelor's degree or advanced degree (PharmD, M.S.) in pharmacy.

• Over 3 years of combined experience in managed care pharmacy or pharmacy residency programs.

• Valid state Pharmacist license with no restrictions.

• Preference for candidates located in the CST or EST time zones.

• Availability during the first 6 months for training and work hours, ensuring at least 75% overlap with the team's schedule of 8:00 AM–4:30 PM PST.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase program.

• Tuition reimbursement opportunities.

• Paid time off along with holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional incentives may be included in the overall compensation package.