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Job Description
- Req#: R8734
- Work with internal and external stakeholders to execute all implementation tasks associated with new market implementation including, but not limited to formulary work, pharmacy benefit testing, clinical policy creation etc.
- Review state contracts to ensure all clinical requirements are documented, met and executed.
- Represent pharmacy implementation for all markets and products by providing readout, status and challenges associated with clinical implementation tasks.
- Support the implementation of cost-effective formularies to drive best clinical practice
- Provide clinical implementation oversight including working with the PBM and internal stakeholders to ensure output is compliant, accurate, and expected results are delivered/met
- Support documentation of policies, procedures, and workflow documentation associated with market implementation
- Perform any other job-related instructions as requested
- Bachelor’s degree in pharmacy is required; Doctor of Pharmacy Degree (PharmD) is preferred
- Prior experience in clinical implementations, formulary development and execution, clinical configuration (including criteria development), medical drug management, configuration and testing, and claims oversight is required
- A minimum of two (2) years of managed care experience required; Medicare, Marketplace, and/or Medicaid lines of business experience is preferred
- Experience working with PBMs, process improvement and the implementation life cycle is required
- Project management and process mapping experience is preferred
- Ability to work flexibly and cross-functionally on a wide variety of projects
- Ability to handle multiple priorities/projects simultaneously
- Strong clinical expertise and healthcare administration understanding
- Knowledge of PBM and medical drug claims workflow and processing applications
- Demonstrated advanced computer skills/proficiency with Microsoft Word, Excel, search engines, and bibliographic software
- Advanced analytical skills, with the ability to interpret and synthesize complex healthcare data and literature
- Excellent verbal and written communications skills
- Excellent presentation and decision-making skills
- Excellent organization and tracking skills
- Excellent problem solving skills
- Ability to interface and collaborate with employees at all levels
- Unrestricted registered pharmacist (RPh) Licensure in state of practice is required
- General office environment; may be required to sit or stand for extended periods of time
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
Job Summary:
The Pharmacist - Implementation is responsible for providing direct support to all new market implementations. This role will facilitate and execute all clinical implementation tasks in partnership with various internal and external stakeholders.
Essential Functions:
Education and Experience:
Competencies, Knowledge and Skills:
Licensure and Certification:
Working Conditions:
Compensation Range:
$92,300.00 - $161,600.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
About the company
CareSource is a nonprofit that began as a managed health care plan serving Medicaid members in Ohio.