Senior Formulary Pharmacist (REMOTE) Job at Inland Empire Health Plans
Position Summary/Position
The Senior Formulary Pharmacist will be in charge of overseeing formulary activities and be the lead regarding Medicare formulary submissions and annual formulary build. The Senior Formulary Pharmacist will work with the Manager, Clinical Pharmacist Operations in execution of formulary strategy to ensure regulatory compliance, cost-effectiveness, and patient access. Major Functions (Duties and Responsibilities)
1. Under direction of Director of Clinical Pharmacy and Product Strategy, project manage and develop formulary strategies based on evaluation of current clinical, financial, utilization, drug pipeline, rebate, and/or regulatory information under the guidance of the Pharmacy Formulary & Utilization Management Director
2. Collaborate with other pharmacy units to identify and implement interventions to the formulary as required for current plan year maintenance and future plan year formulary development
3. Ensure accurate installation and administration of formularies and drug utilization review setup for pharmacy claim adjudication through collaboration with the applications team
4. Oversee creation and maintenance of formulary-related notices and postings in compliance with State and Federal regulatory requirements
5. Participate in CMS, DHCS, and any other regulatory audits and surveys related to formulary administration and develop corrective action or process improvement plans under the guidance of management.
6. Evaluate and implement policies, procedures, and standards of practice related to formulary management ensuring alignment with departmental and regulatory requirements.
7. Provide subject matter expertise oversight and assistance in the completion of Medicare and Medi-Cal user acceptance testing, compliance related system reports, brand/generic drug availability, and drug migration
8. Maintain knowledge of CMS Medicare Part D and DHCS regulations related to formulary management and administration
9. Participate in P&T subcommittee meetings and/or other activities that are related to formulary setup and maintenance
10. Participate in quality and continuous process improvement.
11. Position will have expectations to carry out duties of Clinical Pharmacists (prior authorization, medication reconciliation, medication therapy management, and others). Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Guides Others Experience Qualifications
Four (4) years of combined retail, managed care, HMO, PBM experience with specific experience in clinical pharmacy programs including P&T and formulary.
OR
Completion of a managed care residency (PBM or Health Plan) with rotations in P&T and Formulary.
OR
Completion of a non-managed care residency plus one (1) year of experience in any pharmacy setting. Preferred Experience Education Qualifications
Doctor of Pharmacy (Pharm. D.) from an accredited institution required. Preferred Education Professional Certification Professional Licenses
Possession of an active, unrestricted, and unencumbered Registered Pharmacist license issued by the California State Board of Pharmacy preferred. Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement
Knowledge of pharmacy benefits, formulary, and pharmacy and therapeutics committee. Skills Requirement Abilities Requirement Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions
Schedule may adjust based on business need which may include evenings, holidays, and weekends.
Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership. Work Model Location Telecommute Physical Requirements Keyboarding: Traditional - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Hearing: One-on-One - FREQUENTLY Near Visual Acuity - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Sitting - CONSTANTLY Lighting - CONSTANTLY Indoors - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY
A reasonable salary expectation is between $153,670.40 and $195,936.00, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Please Note :
www.bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
The Senior Formulary Pharmacist will be in charge of overseeing formulary activities and be the lead regarding Medicare formulary submissions and annual formulary build. The Senior Formulary Pharmacist will work with the Manager, Clinical Pharmacist Operations in execution of formulary strategy to ensure regulatory compliance, cost-effectiveness, and patient access. Major Functions (Duties and Responsibilities)
1. Under direction of Director of Clinical Pharmacy and Product Strategy, project manage and develop formulary strategies based on evaluation of current clinical, financial, utilization, drug pipeline, rebate, and/or regulatory information under the guidance of the Pharmacy Formulary & Utilization Management Director
2. Collaborate with other pharmacy units to identify and implement interventions to the formulary as required for current plan year maintenance and future plan year formulary development
3. Ensure accurate installation and administration of formularies and drug utilization review setup for pharmacy claim adjudication through collaboration with the applications team
4. Oversee creation and maintenance of formulary-related notices and postings in compliance with State and Federal regulatory requirements
5. Participate in CMS, DHCS, and any other regulatory audits and surveys related to formulary administration and develop corrective action or process improvement plans under the guidance of management.
6. Evaluate and implement policies, procedures, and standards of practice related to formulary management ensuring alignment with departmental and regulatory requirements.
7. Provide subject matter expertise oversight and assistance in the completion of Medicare and Medi-Cal user acceptance testing, compliance related system reports, brand/generic drug availability, and drug migration
8. Maintain knowledge of CMS Medicare Part D and DHCS regulations related to formulary management and administration
9. Participate in P&T subcommittee meetings and/or other activities that are related to formulary setup and maintenance
10. Participate in quality and continuous process improvement.
11. Position will have expectations to carry out duties of Clinical Pharmacists (prior authorization, medication reconciliation, medication therapy management, and others). Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Guides Others Experience Qualifications
Four (4) years of combined retail, managed care, HMO, PBM experience with specific experience in clinical pharmacy programs including P&T and formulary.
OR
Completion of a managed care residency (PBM or Health Plan) with rotations in P&T and Formulary.
OR
Completion of a non-managed care residency plus one (1) year of experience in any pharmacy setting. Preferred Experience Education Qualifications
Doctor of Pharmacy (Pharm. D.) from an accredited institution required. Preferred Education Professional Certification Professional Licenses
Possession of an active, unrestricted, and unencumbered Registered Pharmacist license issued by the California State Board of Pharmacy preferred. Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement
Knowledge of pharmacy benefits, formulary, and pharmacy and therapeutics committee. Skills Requirement Abilities Requirement Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions
Schedule may adjust based on business need which may include evenings, holidays, and weekends.
Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership. Work Model Location Telecommute Physical Requirements Keyboarding: Traditional - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Hearing: One-on-One - FREQUENTLY Near Visual Acuity - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Sitting - CONSTANTLY Lighting - CONSTANTLY Indoors - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY
A reasonable salary expectation is between $153,670.40 and $195,936.00, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Please Note :
www.bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.