
Clinical Pharmacist IV
MADISON, WIJobSeen todaySeen in employer's feed today
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Job overview
The Clinical Pharmacist works with internal and external stakeholders to advance pharmacy strategy, utilization management, clinical programs, regulatory requirements, and performance. The role applies clinical expertise and data analysis to identify pharmacy cost and trend drivers, develop mitigation strategies, and support initiatives intended to improve clinical and financial outcomes. It also partners with PBMs on formulary execution and advises the organization as a clinical pharmacy subject matter expert.
Skills & qualifications
Skills
Full job description
JOB REQUIREMENTS: Description Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. The Clinical Pharmacist works collaboratively with internal and external stakeholders to advance pharmacy strategy, utilization management, clinical programs, regulatory requirements, and pharmacy performance. This role applies clinical expertise and data analysis to identify opportunities, evaluate pharmacy spend and trend drivers, develop mitigation strategies, and support initiatives that improve clinical and financial outcomes. The role also partners with PBMs on formulary execution and serves as a clinical pharmacy subject matter expert across a matrixed organization. Performs other duties as assigned. Key Accountabilities Monitor pharmacy utilization, spend, and trend performance; identify key cost drivers, emerging patterns, and areas of opportunity across the pharmacy benefit. Partner with Analytics and business stakeholders to conduct pharmacy spend and trend analysis, including forecasting, utilization impact assessment, variance analysis, and development of actionable insights. Develop and support evidence-based strategies to mitigate adverse pharmacy trends and improve clinical and financial performance, including targeted clinical program and utilization management opportunities. Serve as a clinical pharmacy subject matter expert and advisor to internal partners; translate complex pharmacy information and data into clear recommendations for decision makers. Oversee and coordinate pharmacy-related operational, regulatory, and compliance activities, including required reporting, submissions, audits, transparency requests, and documentation. Collaborate with pharmacy vendors, PBM partners, provider organizations, and other external stakeholders to support effective pharmacy program operations and performance. Partner closely with PBM partners on formulary execution, including implementation and maintenance of formulary changes, operational alignment, issue resolution, and ongoing monitoring to ensure intended formulary strategy is accurately executed. Identify and communicate targeted performance improvement opportunities across the organization and support implementation through cross-functional collaboration. Respond to member,... For full info follow application link. Equal Opportunity Employer including Veterans and Disabled Individuals ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/BA8457C3222B4624
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