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Clinical Pharmacist

Premera Blue Cross · États-Unis

New
🇬🇧 English
clinical drug utilization management formulary management prior authorization medication reconciliation disease management algorithms NCQA HEDIS

Job description

About the role

Premera is seeking a Clinical Pharmacist to lead and enhance clinical pharmacy programs that ensure safe, effective, and cost‑efficient medication use. The role combines data‑driven analysis with collaboration across pharmacy, medical, and case‑management teams to improve health outcomes and meet quality metrics.

Key responsibilities

  • Support medical management and clinical pharmacy initiatives for commercial and government lines of business through research, analysis, and program administration.
  • Provide clinical drug utilization and formulary management support to internal and external stakeholders.
  • Administer Pharmacy Prior Authorization and other clinical pharmacy programs.
  • Develop clinical drug information, write case studies, and create standard‑of‑care algorithms.
  • Perform medication therapy management, case and disease management, and medication reconciliation.
  • Identify and resolve drug‑related issues in partnership with medical directors, case managers, and disease managers.
  • Assist case managers in removing barriers to care and design drug‑therapy components of disease‑management algorithms.
  • Recommend interventions to meet accreditation requirements such as NCQA and HEDIS.

Required profile

  • Pharmacy degree with licensure as a pharmacist.
  • Experience in clinical drug utilization management, formulary management, or similar pharmacy practice settings.
  • Strong analytical skills and ability to translate data into actionable pharmacy strategies.
  • Excellent communication skills for collaboration with multidisciplinary teams.

Required skills

  • Clinical drug utilization management
  • Formulary management
  • Prior authorization processes
  • Medication reconciliation
  • Disease‑management algorithm development
  • Knowledge of NCQA and HEDIS accreditation standards

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Published 7 hours ago

Expires 1 month from now

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Premera Blue Cross

États-Unis