Clinical Administrative Pharmacist

Job Description Exemption Status: United States of America (Exempt) Pay scale information: $128,974 - $183,144 - $237,313. Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate. This position is not eligible for Sponsorship. Summary The Clinical Administrative Pharmacist possesses an exceptional working knowledge of Medicaid program pharmacy coverage and payment rules, along with in‑depth experience in managing accounts and clinical projects. This position is dedicated to optimizing the clinical quality and cost‑effectiveness of drug therapy for a state Medicaid agency and its members. The role focuses on the rational management of drug utilization, employing analytical tools and an evidence‑based approach to achieve lower net costs, better health outcomes, and high levels of satisfaction for plan sponsors and their members. In addition to account/contract management responsibilities, the Clinical Administrative Pharmacist serves as both the subject matter expert and the team lead for specific account(s). The Clinical Administrative Pharmacist provides guidance, coordinates tasks, and when necessary, delegates tasks among junior team members to ensure service levels meet client expectations. This position collaborates with corporate resources to achieve overall account and company financial goals. It relies on data and performance indicators, along with experience and judgment, to identify and promote performance improvement opportunities that meet the aligned goals of MedImpact and the client. Essential Duties and Responsibilities Provides support for the state client PA process, Appeals, Pharmacy Lock‑In process, and assistance with Pharmacy Audit process. Monitors contractual Service Level Agreements (SLAs) related to clinical services for managed account(s) and reports to leadership if risks are observed. Provides recommendations to assigned clients that align with the clients' goals of achieving lower net costs and high clinical quality. Strategic recommendations may include benefit design and Preferred Drug List (PDL) analysis and suggestions, provision of clinical drug information, utilization management criteria development, Pharmacy & Therapeutics (P&T) support and participation, recommendations for rational drug PDL positioning, online system edits and restrictions, ongoing clinical product evaluations, and recommendations regarding client pharmacy benefit utilization and performance trends. Offers clinical and Medicaid consultative services in accordance with contracted services. Acts as an integral part of designing, developing, and driving the clinical components of the assigned account team's strategic and financial goals. The CAE II focuses on using a variety of analytical tools and clinical resources to identify opportunities that simultaneously improve the plan sponsor's quality‑focused and financial performance metrics. Identifies and promotes MedImpact's evidence‑based interventions and communication programs to clients, providing documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g., rebate enhancement, lower net cost, generic programs, QA programs). Recommends clinically appropriate PDL changes, considering the lowest net cost after rebates, market shifts, and utilization. Coordinates clinical utilization analyses and presentations to clients, ensuring timely and accurate review of plan data according to policy and offering appropriate intervention recommendations. Coordinates the clinical support of Preferred Drug Lists during plan sponsor implementation. Participates in quarterly state P&T meetings as stipulated by client contracts. Supervisory Responsibilities No supervisory responsibilities. Client Responsibilities This is an internal and external client‑facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). Readily available to state staff during working hours. One must be able to manage difficult or emotional client situations; respond promptly to client needs; solicit client feedback to improve service; respond to requests for service and assistance from clients; meet commitments to clients. Qualifications Education and/or Experience PharmD and 5+ years' experience or equivalent combination of education and experience, and 3 years' of SME in respective areas. Must hold current Tennessee Board of Pharmacy licensure or complete license reciprocity prior to contract go‑live date. Computer Skills Knowledge of Microsoft Office Suite and experience with at least one business intelligent tool (IBM Cognos or Tableau preferred). Certificates, Licenses, Registrations Registered Pharmacist license in good standing and the ability to obtain licensure in specific state as necessary within 6 months. Other Skills and Abilities Familiar with First Databank and Medi‑Span drug information. Analytical skills required to perform drug cost expenditure impact analysis. Exceptional communication skills and interpersonal skills to interface with clients and internal team members. Reasoning Ability Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Mathematical Skills Candidates must have an understanding of pharmaceutical calculations including fractions, decimals, ratios, proportions, percentages, and medication dosing. In addition, candidates must have the ability to calculate and/or interpret market shares and graphs. Language Skills Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Competencies Composure Decision Quality Organizational Agility Problem Solving Customer Focus Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy Physical Demands While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand, walk, use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Work Environment This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (business office with computers and printers, light traffic). Work Location This position must be located in Tennessee. Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, and vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders. Working Hours This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm. Travel This position may require domestic travel. The Perks Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus Equal Opportunity Employer, Male/Female/Disabilities/Veterans. OSHA/ADA. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. #J-18808-Ljbffr JobRx, Inc.