Clinical Pharmacist – Care Team

This is a fully remote position, open to applicants in Texas.

📋 Description

• Assist members in managing their medications and health conditions as the “Pharmacist in the Family.”

• Interact with members through phone, chat, and email to deliver a premium concierge experience.

• Address member inquiries related to pharmacy matters.

• Conduct both prospective and retrospective drug utilization reviews as well as comprehensive medication reviews.

• Suggest modifications to patients’ medication regimens.

• Collaborate with Rightway’s Navigation team to deliver comprehensive support to members.

• Communicate with healthcare providers concerning medication therapy gaps, recommendations for drug therapy, formulary adherence, and medication expertise.

• Participate in research for the Pharmacy & Therapeutics committee, including drug monographs, therapeutic category reviews, and the development of clinical policies.

• Assist in prior authorization reviews related to medication selection and formulary adherence.

• Conduct utilization management reviews and outreach to both members and providers to achieve clinical and cost-saving outcomes.

• Work with third parties on implementing Rightway’s clinical pharmacy strategy.

• Meet productivity and quality metrics for clinical pharmacy interactions.

• Contribute to technology-driven processes to create a scalable clinical pharmacy operation.

• Ensure compliance with regulatory standards is consistently achieved.

⛳️ Requirements

• A degree in Pharmacy is required; a PharmD is preferred.

• Minimum of 3 years of experience in direct patient care, such as within PBM clinical operations, Health Plan Pharmacy Department, or Medication Therapy Management services.

• A state pharmacy license is required in the state of residence.

• Multi-state licenses are preferred, along with a willingness to obtain licensure in additional states.

• Experience in Managed Care or completion of a pharmacy residency is preferred.

• Possess an empathetic nature, attention to detail, intellectual curiosity, clinical inquisitiveness, and strong listening skills, along with the ability to challenge the status quo.

• Strong problem-solving and prioritization abilities; adept at managing through change.

• Excellent communication skills.

• Capability to lead projects and influence others without direct reporting-line authority.

🏝️ Benefits

• Bonus opportunities.

• Equity participation.

• Occasional travel may be necessary.