[Hiring] Formulary Administration Pharmacist @MedImpact Healthcare Systems Inc.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Formulary Administration Pharmacist manages operational aspects of business unit, department; acts as the subject matter expert (SME) to lead and support the execution of strategic initiatives, projects, and/or programs under guidance of Director and/or Manager, Formulary Administration & Strategy. This position focuses on the efforts of the MedImpact Formulary Administration & Strategy Team in quality control and analysis of MedImpact client formulary set-up, rule sets, coding, accuracy, functionality, EOB, documentation, and concordance with client specified and regulatory requirements utilizing distinct but inter-related management and cross-departmental functions. • Maintains, facilitates access to, and distributes clinical formulary information, formulary product descriptions, recommendations for rational drug formulary positioning, application, and revision, when necessary, of standard utilization management, and recommendations regarding client pharmacy benefit expenditures and utilization. • Collaborates with Industry Relations for financial strategy, and Configuration Services for operational support. • Is knowledgeable of regulatory constraints on the pharmacy benefit and ensures compliance with Federal and State regulations for all line(s) of business (e.g. Medicaid, Commercial, and Health Insurance Exchange). • Supports Medicaid/Commercial/Health Insurance Exchange Formulary Administration as follows: Formulary creation and maintenance, utilization management creation and maintenance. • Collaborates with GPS, Compliance and other departments to ensure generation of regulatory compliance, reporting, and submission files. • Collaborates with Industry Relations to provide clinical oversight and ensure financial strategy is properly operationalized. • Participates in meetings as necessary. • Support client teams with custom client formulary strategy recommendations. • Support of Formulary Decision Review meetings: attend meeting as clinical/operational support. • Develops formulary strategy and recommendations such as drug and UM positioning (quantity limits, step edit and prior authorization guidelines) in response to newly approved therapeutic agents, patent expirations, FDA alerts and drug recalls or withdrawals. • Researches and appropriately responds to formulary drug placement and UM rationale and coding questions. • Manages formulary activities related to MedImpact Standard and Custom formularies. • Manages formulary change process including appropriate formulary content, application of utilization management activities, printed formularies, Plan Finder formulary files and the functions as required. • Ensures that the review, coding and quality control of formulary changes occur in an appropriate, accurate, and timely manner based on client-specific parameters. • Ensures appropriate, accurate, and consistent client specific formulary claims adjudication, formulary flat file and Plan Finder file concordance. • Provides direct client consultation on all Formulary Administration and Strategy operations, programs, and software. • Responsible for accurate and timely task estimation and status reporting to Director/Manager, Formulary Administration & Strategy. • Provides formulary-specific documentation of maintenance activities to clients and regulatory bodies as appropriate. • Partners with other departments on a weekly, quarterly and ad hoc basis on the Formulary decision process. • Contributes to internal and external client notifications of timely clinical issues through daily, monthly and quarterly established communications. Qualifications • PharmD and 3+ years’ experience or equivalent combination of education and experience, and 1 year of SME in respective areas Requirements • Knowledge of Microsoft Office, Outlook and a working knowledge of relational databases • Registered Pharmacist in the State of California or equivalent state Benefits • Medical / Dental / Vision / Wellness Programs • Paid Time Off / Company Paid Holidays • Incentive Compensation • 401K with Company match • Life and Disability Insurance • Tuition Reimbursement • Employee Referral Bonus