• Assists in the development of pharmacy solutions programs, including the creation of prior authorization criteria.

• Supports both prospective and retrospective Drug Utilization Review (DUR) activities by analyzing physician prescribing behaviors.

• Offers consultation on pharmacy-related matters to representatives in clinical operations.

• Leads and/or aids in operational initiatives and projects, including strategic planning and implementation.

• Assesses drug and drug class reviews based on credible, evidence-based research.

• Engages in conversations with practicing physicians and other prescribers to provide consultation on specialty medication prescribing.

• Regularly reviews and monitors prescription claims data to identify prescribing outliers.

• Collaborates with Gainwell staff to reach out to prescribers needing consultation.

• Active State Licensure as a Registered Pharmacist.

• PharmD (preferred) or a Bachelor of Pharmacy degree.

• At least 5 years of experience in clinical pharmacy or PBM.

• Familiarity with Medicaid at the state and/or federal level.

• Understanding of pharmacy-related components of Medicaid.

• Experience participating in P&T Committees and DUR Boards.

• Proficient in clear and accurate communication in both written and spoken English.

• Capable of performing clinical reviews utilizing relevant compendia and clinical trial data.

• Experience in managed care pharmacy is advantageous.

• Strong research and implementation abilities in practical settings.

• Excellent analytical skills with the capacity to translate findings into actionable recommendations.

• Strong team player with respect for all team members.

• Strong interpersonal skills to facilitate collaboration with both internal and external stakeholders.

• Outstanding organizational, written, and verbal communication skills.

• Maintains confidentiality and adheres to HIPAA regulations.

• Proficient in Microsoft Office applications and quick to learn proprietary systems.

• Strong organizational and problem-solving capabilities.

• Generous and flexible vacation policy.

• 401(k) employer match.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.

Clinical Pharmacist

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