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Clinical Pharmacist, Formulary Services
@Abarca Health
[Hiring] Clinical Pharmacist, Formulary Services @Abarca Health
Apr 01, 2025 - Abarca Health is hiring a remote Clinical Pharmacist, Formulary Services. 💸 Salary: unspecified. 📍Location: Puerto Rico.
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
As a Clinical Pharmacist for Formulary Services, you will be responsible for developing and implementing Medicare, Medicaid, and Exchange formulary programs while ensuring compliance with external regulatory guidelines.
- Develop and implement Medicare, Medicaid, and Exchange formulary programs.
- Stay current with external regulator guidelines to make timely adjustments to operations ensuring our processes follow the rules and regulations.
- Independently perform as well as consult and advise the team through research and resolution of adjudication and processing issues including identification of root cause, impact analysis determination and corrective action.
- Resolution & Ownership of project-based work as assigned.
- Perform client or prospect client facing to present demos around the PBM configuration platform.
- Primary support for configuration setup for new Medicare, Medicaid, Commercial and Employer client implementations, as well as configuration changes for existing clients.
- Provide consultative support to clients as well as internal teams.
- Monitor and distribute the workload assignment of the configuration team.
- Identify opportunities and solutions in inventory management that advance efficiency and standards for configuration.
- Collaborate and coordinate both within the configuration teams and with other business units to execute configuration as required.
- Manage client benefit operational calls, key client meetings and requests by capturing significant discussion topics and action items as well as sharing input and solutions to address client needs, considering Abarca’s priorities.
- Continuously develop and maintain an in-depth understanding of Darwin (proprietary adjudication platform) system logics to ensure designs are configured to meet client requirements with accuracy.
- Take part in the Pharmacy & Therapeutics Committee preparing presentations and clinical recommendations for new drugs.
- Research and remain informed of current and emerging trends in formulary and benefit design.
- Actively participate in government and internal audits.
- Engage in CMS Medicare STAR initiatives and clinical programs, as well as Medicare Plan Finder and PDE processes.
- Lead the team through process improvement efforts and recommendations.
- Develop process documentation, including Policies and Procedures, to document Benefit Administration operational processes.
- Support training new team members in configuration setup and standardized quality procedures.
Qualifications
- Doctoral Degree in Pharmacy.
- Current/Active Pharmacy License.
- 3+ years of experience with formulary management within clinical operations, and pharmacy benefit management.
- Experience working within clinical scenarios.
- Excellent oral and written communication skills.
Requirements
- Availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands.
- Availability to work in a specified time zone, accommodating the business needs of our clients and team members based in the determined time zone.
Benefits
- Flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only).
Physical Requirements
- Must be able to access and navigate each department at the organization’s facilities.
- Sedentary work that primarily involves sitting/standing.
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| 📍 | Be aware of the location restriction for this remote position: Puerto Rico |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
Back to Remote jobs >
All others
All others
|
Salary
💸
unspecified
|
Remote
Location
Puerto Rico
|
|
Job Type
full-time
|
Posted
Apr 01, 2025
|
️
| 📍 | Be aware of the location restriction for this remote position: Puerto Rico |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
