Clinical Pharmacist - Utilization Management Archimedes

Posted 22 Days Ago
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Earth City, MO, USA
In-Office
Mid level
Healthtech • Pharmaceutical
The Role
Provides clinical expertise for specialty medication utilization management across pharmacy and medical benefits. Responsibilities include prior authorization, high-cost case management, claims editing, clinical policy and program development, literature and cost-effectiveness evaluation, and peer-to-peer consultations with physicians. The role also communicates clinical recommendations to providers, members, clients, and consultants and supports specialty drug cost management.
Summary Generated by Built In
CompanyArchimedes About UsArchimedes - 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 RangeUSD $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 Remote Work NotificationATTENTION: Archimedes is only able to offer remote work to residents of Alabama, Colorado, Florida, Georgia, Indiana, Illinois, Iowa, Kansas, Kentucky, Maryland, Minnesota, Missouri, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia, Wisconsin. 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 : Address502 Earth City Expy STE 300 Location : CityEarth City Location : State/ProvinceMO Location : Postal Code63045 Location : CountryUS

Skills Required

  • Doctor of Pharmacy (PharmD)
  • Current pharmacist license (RPh) in good standing with a State Board of Pharmacy
  • Board of Pharmacy Certification in Pharmacotherapy, Ambulatory Care, or Oncology Care
  • Three years of clinical or managed care experience, or a clinical/managed care pharmacy residency
  • Pharmacy and medical specialty benefit knowledge and experience
  • Independent, proactive, forward-thinking, creative problem-solving, and results-oriented approach
  • Ability to work well in a team environment
  • Strong verbal and written communication skills
  • Strong physician-facing clinical communication skills
  • Proficiency with Microsoft Excel, PowerPoint, and Word
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The Company
HQ: Madison, WI
771 Employees
Year Founded: 2003

What We Do

A leading applied technology services company, we innovate to deliver service excellence and successful outcomes across sales, delivery and development. With our strategy to be agile, nimble and customer-centric, we anticipate the future of applied technology and predict tomorrow’s trends to keep our clients at the summit in an ever-changing marketplace. Leading with architecture and design, our next-gen solutions enable enterprises to accelerate on their digital transformation journey.

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