Clinical Pharmacist - Cost Containment

Description TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and customized level to ensure optimum value at the lowest possible cost. We are committed to lowering prescription drug spending, achieving clinically effective outcomes, and always delivering A wide range of health insurance options including medical, dental and vision A strong salary and bonus program A robust 401k and company match Truescripts is transitioning to an ESOP, a team member owned company! Each year team members are allocated shares of stock through our ESOP, a Qualified Retirement plan! Employee Assistance Program A wellness program including financial incentives, chiropractic and massage services, and fitness stipends Dream Manager Program (yes, it’s a real thing!) A cohesive, family-based culture Charitable contributions and volunteer time Job Type Full-time Description TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and customized level to ensure optimum value at the lowest possible cost. We are committed to lowering prescription drug spending, achieving clinically effective outcomes, and always delivering Amazing Care. Did we mention Amazing Care? Good! Because this is so much more than just our tagline. It is the foundation upon which our business was built. We believe that Amazing Care starts from within, and our culture is reflective of this philosophy. Our Team Members Enjoy A wide range of health insurance options including medical, dental and vision A strong salary and bonus program A robust 401k and company match Truescripts is transitioning to an ESOP, a team member owned company! Each year team members are allocated shares of stock through our ESOP, a Qualified Retirement plan! Employee Assistance Program A wellness program including financial incentives, chiropractic and massage services, and fitness stipends Dream Manager Program (yes, it’s a real thing!) A cohesive, family-based culture Charitable contributions and volunteer time Ok, enough about us. Here’s what we need from you: A future team members' values need to align with TrueScripts' core values of Integrity, Respect, Innovation, and Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a ‘can do, proactive attitude. Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed. Position Overview The Clinical Pharmacist-Cost Containment Programs is responsible for providing clinical expertise, program oversight, and operational support for TrueScripts' cost containment initiatives. This role partners cross-functionally with Clinical Programs, Operations, Client Services, Pharmacy Networks, and other internal teams to develop, implement, manage, and optimize cost containment programs designed to improve medication utilization, promote appropriate prescribing, and reduce unnecessary prescription drug spend. The ideal candidate combines strong clinical knowledge with an understanding of pharmacy benefit management (PBM), drug utilization, formulary management, and cost containment strategies. This individual will support day-to-day program execution, evaluate clinical and financial outcomes, and help ensure programs deliver meaningful value to clients and their members. Responsibilities Include Cost Containment Program Support and Development Provide clinical pharmacy expertise to support the development, implementation, and ongoing management of cost containment programs. Evaluate prescription drug utilization, prescribing patterns, formulary opportunities, and emerging therapies to identify potential cost savings. Support the design and refinement of cost containment programs that promote clinically appropriate, cost-effective medication utilization. Assist with evaluating new program opportunities by assessing clinical appropriateness, operational feasibility, potential financial impact, and member implications. Evaluate new business member medication disruption and/or transition opportunities that deliver the greatest lowest net cost while maintaining clinical efficacy. Review physician and member inquiries and/or appeals related to the clinical appropriateness of the drug or pharmacy alternatives that deliver the greatest value. Partner with leadership to prioritize initiatives based on potential savings, clinical value, implementation requirements, and client needs. Clinical Program Management and Execution Provide ongoing clinical support for assigned cost containment programs, including program setup, implementation, maintenance, and continuous improvement. Develop and maintain clinical criteria, workflows, program documentation, and operational guidance to support consistent program administration. Support the review and refinement of program rules, clinical criteria, and intervention strategies to ensure appropriate application. Assist with resolving complex clinical questions, exceptions, and escalations related to program administration. Collaborate with internal teams to identify workflow gaps, reduce manual processes, and improve program efficiency. Monitor program performance and identify opportunities to improve effectiveness, consistency, and scalability. Clinical Analysis and Financial Outcomes Analyze drug utilization, claims trends, prescribing patterns, and other relevant data to identify clinical and financial opportunities. Partner with Analytics, Finance, and other stakeholders to evaluate program performance and validate savings opportunities. Support the development of program metrics, reporting, and performance dashboards that measure utilization, financial impact, and clinical outcomes. Review program results to identify trends, unexpected outcomes, and opportunities for adjustment. Assist with documenting program value and communicating clinical and financial results to internal stakeholders and clients. Help ensure cost containment recommendations balance financial performance with patient safety, appropriate care, and member experience. Cross-Functional Collaboration Partner with Pharmacy Networks, Client Services, Implementation, Compliance, and other departments to resolve program-related questions and operational challenges. Provide clinical education and guidance to internal team members supporting cost containment programs. Participate in client discussions, program reviews, and internal strategy sessions as needed to explain clinical approaches and program value. Support the development of standardized processes, resources, and training materials that improve internal understanding and administration of cost containment initiatives. Identify opportunities to strengthen communication, accountability, and coordination between teams responsible for program delivery. Compliance, Quality, and Continuous Improvement Support compliance with applicable federal and state requirements, contractual obligations, clinical standards, and internal policies. Maintain appropriate documentation of clinical decisions, program criteria, and program changes. Identify potential risks, quality concerns, and process gaps and elevate them to the appropriate leaders. Stay current on pharmaceutical trends, emerging therapies, drug pricing developments, and industry practices relevant to cost containment. Recommend process improvements that enhance program quality, reduce unnecessary administrative effort, and support scalable growth. Requirements Doctor of Pharmacy (Pharm.D.) degree from an accredited college of pharmacy. Active pharmacist license in good standing in the state of residence, with the ability to obtain additional licensure as required by the position. Strong clinical knowledge of pharmacotherapy, medication utilization, formulary management, and evidence-based prescribing. Demonstrated analytical, problem-solving, and critical-thinking skills. Ability to interpret clinical information and translate findings into practical recommendations. Strong written and verbal communication skills. Ability to collaborate effectively across departments and with stakeholders at varying levels of the organization. Strong organizational skills and the ability to manage multiple priorities in a growing, fast-paced environment. Preferred Experience working in a pharmacy, PBM, healthcare, or clinical environment. Familiarity with formulary management or pharmacy benefit operations. Experience supporting clinical programs or healthcare initiatives. Experience working with spreadsheets, reporting tools, workflow systems, or project-management tools. Familiarity with pharmacy terminology and clinical program concepts. Experience documenting processes and developing standard operating procedures. SQL experience is a plus. Working Conditions Primarily remote position with some travel to the TrueScripts office in Washington, Indiana, for meetings, team events, training, and cultural activities as needed. Estimated 20-25% travel required. #J-18808-Ljbffr