[Hiring] Clinical Formulary Pharmacist @Centene Corporation

Role Description

Define and develop standard and custom formularies for all lines of business including Commercial, Medicaid, Medicare Part D and the Health Information Marketplace.

• This is a fully remote position. Candidates located in the CST or EST time zones are preferred.
• During the first 6 months, the selected candidate must be available for training and work hours that provide at least 75% overlap with the team’s 8:00 AM–4:30 PM PST schedule.
• Develop drug product review and formulary recommendations by assessing drug use trends, new drug releases and review of primary literature.
• Analyze pharmacy cost of care, trends, and coordinate the development of appropriate use protocols and guidelines.
• Set criteria for medication analysis, coordinate reports to clients, meet regulatory reporting requirements for drug utilization review and fraud and abuse reporting.
• Develop clinical criteria for review of non-formulary or non-preferred drug lists medications and communicate recommendations to clients.
• Develop and design clinical edits to adjudicate claims and enhance drug utilization.
• Develop and review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design.
• Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews.
• Provide clinical guidance and support to the assigned pharmacy technicians.
• Provide support documentation and develop communication for the Pharmacy & Therapeutic (P&T) Committee review process and decisions.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy.
• 3+ years of combined managed care pharmacy or pharmacy residency program experience.

Requirements

• Current state’s Pharmacist license with no restrictions.

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible approach to work with remote, hybrid, field or office work schedules.