N

Clinical Pharmacist, Utilization Management - Archimedes

Navitus Health Solutions
Full-time
On-site
Missouri, United States
Overview
Archimedes is a specialty drug management company with industry-leading technology and services that health plans and employer groups can use to manage specialty drug spend. We are expanding our team and looking for a clinical professional who has specialty drug management experience and a passion for cost management. Given our continued growth trajectory, we are looking for a person who can grow with the company.

This role will be divided into two areas: external clinical outreach activities related to high-cost case management and prior authorization of specialty medications, across pharmacy and medical benefits and specialty and traditional drugs. In addition, this role will have the opportunity to evaluate the data to identify actionable opportunities for specialty management and create clinical policies.

The Clinical Pharmacist is responsible for being the clinical expert for all specialty medications across both the pharmacy and the medical benefit. This individual will be able to successfully communicate with physicians, nurses, pharmacists, and members related to high-cost case concerns, dose management, genetic testing, therapeutic substitutions and cost management related to specialty drugs. Clinical subject matter expert is required to conduct peer to peer consultations with physicians.

Responsibilities

Develop and deliver clinical messages to physicians, members, clients, and consultants

Manage prior authorization, high-cost cases, claims editing and clinical policy development

Clinical program development including both medical and pharmacy benefit management

Define, document, and deliver results for plan sponsors.

Evaluate and summarize clinical literature as well as financial implications related to medication management options

Ability to present deep clinical and cost effectiveness information as a peer-to-peer consult.

Qualifications

Doctor of Pharmacy (PharmD)

Current pharmacist license (RPh) in good standing with a State Board of Pharmacy

Board of Pharmacy Certification preferred for Pharmacotherapy, Ambulatory Care or Oncology Care

3 years clinical or managed care experience or Clinical/Managed Care Pharmacy Residency preferred

Location: St. Louis, Missouri

Pharmacy and Medical specialty benefit knowledge and experience

Independent, proactive, forward-thinking, creative problem solver, results-oriented

Ability to work well in team environment

Strong verbal/written communication skills

Strong physician-facing clinical communication skills

Microsoft Excel, Power Point and Word proficiency

Location
502 Earth City Expy STE 300, Earth City, MO 63045, US

#J-18808-Ljbffr
Apply now
Share this job