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Home Flexible Job Board Clinical Pharmacist - Utilization Management Archimedes

Salary Unstated 128d ago

Clinical Pharmacist - Utilization Management Archimedes

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Navitus Health Solutions, LLC

Bridgeton, MO, US

Full-time Permanent Remote

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Summary

The Clinical Pharmacist serves as the subject matter expert for specialty medications across pharmacy and medical benefits. Responsibilities include managing prior authorizations, conducting peer-to-peer consultations with physicians, and developing clinical policies to optimize cost management.

Job Description

Company

Archimedes

About Us

Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit – alignment, value and transparency – Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. .____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $0.00 - USD $0.00 /Yr.

STAR Bonus % (At Risk Maximum)

0.00 - Ineligible

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am to 5pm Hybrid In Office- 3 Days

Overview

Archimedes is a specialty drug management company with industry-leading technology and services that health plans and employer groups can use to manage specialty drug spend. We are expanding our team and looking for a clinical professional who has specialty drug management experience and a passion for cost management. Given our continued growth trajectory, we are looking for a person who can grow with the company.

This role will be divided into two areas: external clinical outreach activities related to high-cost case management and prior authorization of specialty medications, across pharmacy and medical benefits and specialty and traditional drugs. In addition, this role will have the opportunity to evaluate the data to identify actionable opportunities for specialty management and create clinical policies.

The Clinical Pharmacist is responsible for being the clinical expert for all specialty medications across both the pharmacy and the medical benefit. This individual will be able to successfully communicate with physicians, nurses, pharmacists, and members related to high-cost case concerns, dose management, genetic testing, therapeutic substitutions and cost management related to specialty drugs. Clinical subject matter expert is required to conduct peer to peer consultations with physicians.

Position can be located in either our Brentwood, TN or St Louis, MO offices.  Remote employment also considered.  

Responsibilities

  • Develop and deliver clinical messages to physicians, members, clients, and consultants
  • Manage prior authorization, high-cost cases, claims editing and clinical policy development
  • Clinical program development including both medical and pharmacy benefit management
  • Define, document, and deliver results for plan sponsors.
  • Evaluate and summarize clinical literature as well as financial implications related to medication management options
  • Ability to present deep clinical and cost effectiveness information as a peer-to-peer consult.

Qualifications

  • Doctor of Pharmacy (PharmD)
  • Current pharmacist license (RPh) in good standing with a State Board of Pharmacy
  • Board of Pharmacy Certification, preferred for Pharmacotherapy, Ambulatory Care or Oncology Care
  • 3 years clinical or managed care experience or Clinical/Managed Care Pharmacy Residency preferred.
  • Pharmacy and Medical specialty benefit knowledge and experience
  • Independent, proactive, forward-thinking, creative problem solver, results-oriented
  • Ability to work well in team environment
  • Strong verbal/written communication skills
  • Strong physician-facing clinical communication skills
  • Microsoft Excel, Power Point and Word proficiency

Location : Address

502 Earth City Expy STE 300

Location : City

Earth City

Location : State/Province

MO

Location : Postal Code

63045

Location : Country

US

About the company

Navitus Health Solutions, LLC

Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.

Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.

Founded

2003

Company size

1,001-5,000 employees

Industry

Hospitals and Health Care

Org type

Privately Held

Headquarters

Madison, WI

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About the company

Navitus Health Solutions, LLC

Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.

Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.

Founded

2003

Company size

1,001-5,000 employees

Industry

Hospitals and Health Care

Org type

Privately Held

Headquarters

Madison, WI

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