Medica’s Clinical Pharmacists works in conjunction with key internal and external stakeholders to drive the strategy supporting the pharmacy formularies, utilization management (UM), and clinical programs. 

Areas of focus include Commercial formulary optimization, pharmacy pipeline monitoring/utilization predictions, formulary assessment and new UM policy development to support formal Pharmacy & Therapeutics (P&T) Committee approvals.  The incumbent will keenly anticipate key market events and incorporate into strategic recommendations in consideration with local or regional trends.

 Key Accountabilities

• Monitor the drug pipeline and partner with Analytics to predict utilization impact
• Evaluate clinical literature to draft clinical drug information to support formulary placement and UM strategies for all classes of drugs presented for approval at P & T
• Partner with internal clinical pharmacy team and Analytics to analyze pharmacy trends to develop negative trend mitigation strategies
• Understand and promote clinical pharmacy program strategies such as biosimilar utilization optimization
• Serves as clinical pharmacy subject matter expert and advisor
• Actively participate in internal and external clinical pharmacy meetings necessary to support key accountabilities
• Educate and promote targeted performance improvement opportunities across the enterprise
• Oversees and partners with key stakeholders in formulary management, clinical programs, and regulatory and compliance needs

Strategic goals are focused on clinical and financial performance, and collaborative development of success metrics to evaluate the performance of each program and initiative.  The individual in this role will ensure that such work is done in compliance with applicable state and federal regulations. 

It's important that our Clinical Pharmacist has a strong understanding of P & T processes, PBM and/or health plan business practices, and the competitive landscape. This position will need to effectively navigate a large health care organization and understand the unique needs of customers including members, providers, and internal peers.

Qualifications

• Bachelor’s degree in Pharmacy required; PharmD preferred
• 7+ years of related experience

Certifications/Licensure

• Valid, registered pharmacy license (in any state)

Skills and Abilities

• Prior experience with P&T/formulary management from a health plan or PBM standpoint is required
• Experience working in a matrixed or multi-disciplinary environment is preferred
• Organized individual who can simultaneously balance and- execute through multiple projects and priorities
• Self-starter, possessing willingness and ambition to work through ambiguity
• Creative thinker
• Motivated to problem solve
• Public speaking with polished presentation style
• Collaborative, team-oriented spirit
• Excellent written and verbal communication skills
• Customer/patient focused
• Operates with flexibility in changing business environment
• Proven track record on consistently achieving desired results

This position is a hub-based role which requires onsite presence. To be eligible for consideration, candidates must reside within a commuting distance to one of the following office locations: Madison, WI, Minnetonka, MN, or Omaha, NE. Onsite frequency is determined by business need as decided by leadership and may be up to 2-3 days a week.

The full salary range for this position is $111,200 - $190,600. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting.

Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

About Medica

Medica is a non-profit health insurance company headquartered in Minnetonka, MN with offices in Madison, WI and Omaha, NE. The company is active across the heart of America and provider healthcare coverage in multiple markets. Medica is engaged in our communities through the charitable grant-making work of the Medica Foundation and active employee giving and volunteer programs.

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