Clinical Pharmacist II, COMM and Exchange

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Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

The Clinical Pharmacist II for COMM/Exchange will be responsible for developing and maintaining the COMM and Exchange pharmacy formularies to ensure appropriate coverage and cost effectiveness.

• -Pharmacy and Therapeutics committee support; preparing materials for committee members and collaborating with the PBM on materials that will be presented.
• -Participates as the Chair of the Drug Coverage Committee. Develops agenda and materials with the Clinical Pharmacy team that will be presented. Presents materials that are within scope and ensures committee attendees meet the quorum, and votes are received timely. Assists in the development, implementation, and maintenance of clinical programs.
• -Formulary trend management:
  • o Develops and implements clinical pharmacy strategies which result in high-quality, cost-effective pharmacy management and outcomes
  • o Develops, analyzes, reports on clinical programs, handles, and coordinates between Pharmacy and other collaborators throughout Mass General Brigham Health Plan.
  • o Develops, implements, and leads managed care programs such as prior authorization and quantity limitations programs
  • o Ensures clinical compliance with law and regulatory bodies
  • o Develops educational materials, newsletters, member, and provider talking points, and disseminates clinical information for both internal and external audiences.
  • o Participates in other committees as requested
  • o Works with the Clinical Pharmacy Associates to ensure coding is accurate and reflects the intent of the plan
• -Supports other clinical pharmacy team functions as assigned.
• -Participates in department quality improvement efforts.
• -Performs other duties as assigned.
• -Complies with all policies and standards.

Doctor of Pharmacy required

Pharmacist License required

At least 3-5 years of experience working as a managed care pharmacist preferred

Strong, demonstrated track record of the ability to execute on time, on budget, and on scope. Strong aptitude for technology-based solutions. Ability to inject energy, when and where it’s needed. Current in healthcare trends. Demonstrated forward, visionary thinking; ability to see “what is” and envision “what could be.” Ability to…