Pharmacy Benefit Manager (PBM) Pharmacist
Pharmacy Benefit Manager (PBM) Pharmacist
Managed Staffing, Inc.
United States
See who Managed Staffing, Inc. has hired for this role
Job Title: Pharmacy Benefit Manager (PBM) Pharmacist (Remote)
Position Summary: We are seeking a highly skilled and experienced PBM Pharmacist to join our dynamic team. The ideal candidate will have a strong background in pharmacy benefit management, with a focus on optimizing prescription drug benefits and ensuring the delivery of effective medication therapy.
Key Responsibilities
Position Summary: We are seeking a highly skilled and experienced PBM Pharmacist to join our dynamic team. The ideal candidate will have a strong background in pharmacy benefit management, with a focus on optimizing prescription drug benefits and ensuring the delivery of effective medication therapy.
Key Responsibilities
- Conduct coverage determinations and prior authorizations for prescription drugs, ensuring compliance with workers’ compensation criteria and guidelines.
- Review and analyze workers’ compensation claims data for clinical appropriateness, cost efficiency, and therapeutic outcomes.
- Provide evidence-based recommendations to prescribers, leveraging state-specific workers’ compensation guidelines to ensure optimal drug utilization.
- Monitor drug utilization patterns, identify cost containment opportunities, and implement strategies to enhance drug therapy outcomes for patients.
- Serve as a liaison between insurance companies, pharmacies, and patients to negotiate drug pricing and manage prescription benefits.
- Develop and maintain formulary systems, perform drug utilization reviews, and manage fraud and abuse programs.
- Support client plan benefit design discussions, customizing clinical and reporting requirements to meet individual population needs.
- Bachelor's degree in pharmacy or Pharm D and a valid pharmacist license.
- Least two years experience as a pharmacist
- Strong experience in PBM or related field, with a preference for candidates with account management experience in a PBM environment.
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Seniority level
Mid-Senior level -
Employment type
Contract -
Job function
Human Resources -
Industries
Hospitals and Health Care and Pharmaceutical Manufacturing
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