Pharmacist - Pharmacy Benefit Management
Department Overview
The PBM Pharmacist provides clinical support to OHSU Pharmacy Benefit Management Services. Support
includes but is not limited to formulary management, coverage determinations, Pharmacy and Therapeutics
Committee support, responding to clinical inquiries, and implementing clinical programs.
Function/Duties of Position
Formulary management including but not limited to activities such as adjudication, formulary decision making, and benefit determination.
Respond to and resolve clinical inquiries from members, clients, providers, or pharmacies related to formulary options, therapeutic alternatives, and coverage determinations.
Oversee completion of prior authorization requests for members through collaboration with PBM Pharmacy Technicians.
Coordinate with pharmacy claims processor to ensure formularies, clinical edits, and plan designs are implemented according to requirements.
- Assist with developing and presenting drug monographs, executive summaries, therapeutic class reviews, and medication policies to Pharmacy & Therapeutics Committees.
Utilize claims data to evaluate benefit design for inappropriate utilization and opportunities to improve outcomes and optimize drug spend.
Required Qualifications
- A current Pharmacist’s license issued by the Oregon State Board of Pharmacy.
- B.S. Pharmacy or Pharm.D.
- Pharmacy practice residency or three years equivalent work experience
- 2 years or more in managed care, health plan or pharmacy benefit management setting
Job Related Knowledge, Skills and Abilities (Competencies):
- Drug therapy knowledge (Dosage, indications, side effects, etc.)
- Contemporary medication use systems
- Drug information through written and verbal consults as well as monographs
- Interpersonal communication
- Excellent organizational skills
- Supervisory concepts (for indirect reports)
- Problem solving
Preferred Qualifications
- PBM operational experience
- Specialty pharmacy practice
- Pharmacy benefit design
- Pharmacy & Therapeutics Committee participation
- Medication policy development
- Pipeline development
- Project management skills
Additional Details
The PBM pharmacist will experience competing demands and frequent interruptions from PBM Technicians, clients, members, and other health care professionals.
All are welcome
Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or [email protected].Average salary estimate
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