[Hiring] Clinical Pharmacist - Utilization Management Archimedes @Navitus Health Solutions

Role Description

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.
• 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
• 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

Work Schedule Description

• M-F 8am to 5pm Hybrid In Office - 3 Days