Managed Staffing, Inc.

Pharmacy Benefit Manager (PBM) Pharmacist

Managed Staffing, Inc. United States
Managed Staffing, Inc.

Pharmacy Benefit Manager (PBM) Pharmacist

Managed Staffing, Inc. United States
3 weeks ago 172 applicants

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

  • 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.

Requirements

  • 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.

  • Seniority level

    Mid-Senior level

  • Employment type

    Contract

  • Job function

    Human Resources

  • Industries

    Hospitals and Health Care and Pharmaceutical Manufacturing

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