Clinical Pharmacist Consultant or Sr. DOE

Clinical Pharmacist Consultant or Sr.

Work from home within Oregon, Washington, Idaho or Utah. Candidates must be available to work Pacific Standard Time (PST) hours irrespective of their physical location.

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Every day, Cambia's dedicated team of Pharmacy Consultants are living our mission to make health care easier and lives better. As a member of the Pharmacy Services team, our Clinical Pharmacist Consultants provide professional and clinical pharmacy expertise in making or guiding clinical decisions based on best practices by creating and applying evidence-based medicine evaluations to determine the best quality medication choices that represent the best value in efficacy, safety and affordability.

This may include providing coverage recommendations for medications subject to prior authorization based on applicable medication coverage policies and member benefit contracts or serving as a resource for other staff. This role may also assist in planning, developing, and implementing clinical strategies with respect to formulary management, drug utilization management, and peer-to-peer conversations. Additional responsibilities may include development of position papers, medication coverage policies, formulary monographs and class reviews, cross-functional projects, and/or initiatives related to the provision of pharmacy benefits that impact safety, quality and affordability – all in service of creating a person-focused health care experience.

Do you want to impact medication safety and affordability on a larger scale? Ready to collaborate on cross-functional projects that shape pharmacy benefits? Then this role may be the perfect fit.

Qualifications:

• Bachelor's degree in Pharmacy or Doctor of Pharmacy (PharmD) or related field
• Minimum 3-5 years of experience in clinical acute care/hospital setting or equivalent combination of education and experience
• Pharmacy license. Successful completion of a pharmacy residency or advanced degree in health-related field preferred. Must be an active and unrestricted licensed pharmacist in state of practice

Skills and Attributes:

• Strong clinical pharmacy background with ability to demonstrate clinical therapy skills and knowledge in a clinical care setting.
• Excellent verbal and written communication skills; strong business analytical skills and abilities; strong project management and coordination ability.
• Ability to work independently, to prioritize work, meet deadlines and achieve operational goals
• Demonstrated success in managing professional relationships in a managed care system, medical group, hospital, or related organizations.
• Ability to collaborate as part of cross functional teams, to improve clinical programs, enhance processes and share clinical information.
• Knowledge of pharmaceutical products, including orals, injectables, infusion products, and chemotherapy; state and federal laws and rules regarding the practice of pharmacy and regulation of health care industry practices, such as DOLI, PPACA and HIPAA.
• Strong knowledge of health care economics and financing; health care/pharmaceutical industry dynamics; and pharmacy/provider service reimbursement of medications.
• Knowledge of Health Plan and benefit design structures and application;
  Medicare/CMS regulations and applicability in administering the Medicare Product; health care coding and payment systems (such as ICD-9, CPT, HCPCS, NDC).
• Strong knowledge of compliance related activities, legislative and regulatory activities, health insurance operations, and legal issues.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

• Provide clinical decision-making based on best practices in applying evidence-based medicine process in determining medications that have best value for efficacy and safety.
• Provide coverage recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable…