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Advisory Clinical Pharmacist

Company: Noridian Healthcare Solutions
Location: Fargo
Posted on: March 16, 2019

Job Description:

Job Summary The Advisory Clinical Pharmacist is responsible for researching, developing and implementing retail and medical pharmacy programs that support Blue Cross Blue Shield of North Dakota's (BCBSND) corporate strategies and customer expectations. This position advises and oversees pharmacy activities to achieve the most cost-effective use of the pharmaceutical portion of health care spending while maintaining quality health care for members and improving overall health plan efficiency. The Advisory Clinical Pharmacist coordinates functions internally and with Pharmacy Benefit Manager (PBM), including but not limited to: PBM relationship management, pharmacy networks, formulary management, clinical pharmacy programs, pharmacy program performance analytics, value-based payment program analysis and support, staff development and benefits/claims input. Essential Functions

  • Plays an active role in the development of pharmacy strategies and programs with input from management and pharmacy committee to support strategic pharmacy clinical and cost management goals.
  • Fosters effective PBM relationships and does this by ensuring strong clinical policies, business processes, financial outcomes and business contracts are in place.
  • Oversees and may lead the activities of Pharmacy Steering Committee. Works diligently to ensure this committee functions effectively through meaningful collaboration and solid coordination across the company.
  • Develops, implements, and maintains any clinical pharmacy programs for both retail and medical pharmacy claims. Provides input, recommendations and direction to PBM regarding network management, reimbursement, formularies and clinical programs. Facilitates clinical reviews of individual cases in accordance with clinical policies and procedures.
  • Partners with internal and external individuals and organizations to communicate and share key information about industry trends, policy changes and BCBSND business goals.
  • Collaborates with strategic partners and serves as a primary contact for ND Pharmacy Association and other local pharmacy programs and organizations. Serves as an advisor regarding appropriate medications on formulary.
  • Works to design pharmacy programs that meet the goals of customers, are clinically relevant and cost effective.
  • Researches high cost pharmacy drugs and categories and determines opportunities for cost effective alternatives and designs and implements drug medical policies that reflect current clinical evidence and financial effectiveness.
    • Evaluates and analyzes utilization and prescribing patterns for participating value-based program providers and identifies and presents improvement opportunities to drive improved financial outcomes.
    • Serves as an internal consultant/subject matter expert on pharmacy benefit issues and pharmaceutical technical questions. Provides guidance or mentorship within the department on daily pharmacy functions and processes. Knowledge, Skills and Abilities Coaching Basic Specialized Technical Skills Advanced Research and Data Analysis Intermediate Collaboration Intermediate Clinical Expertise Intermediate Problem Solving and Resolution Intermediate Education Requirements Required: Master's Preferred: Doctorate Field(s) of Study: Registered Pharmacist is required; PharmD is preferred Experience Requirements Required: Minimum of 5 Years Preferred: Minimum of 7 Years Experience Details: Minimum of 5 years of experience in retail/special pharmacy operations and/or pharmacy benefits management or health plan operations is required; experience with population-based health pharmaceutical analysis or disease management programs is preferred. Previous supervisory experience is also preferred. Certification, Licensures& Registration Requirements Title: Registered Pharmacist State or Agency: North Dakota Board of Pharmacy Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards Other Information Job Posting Policy 6.05 New employees with Blue Cross Blue Shield of North Dakota will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply. Equal Opportunity Employment Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity. For questions, please email This job posting will be closed 4/12/2019 at 8:00AM CST. No further applications will be considered.

      Keywords: Noridian Healthcare Solutions, Fargo , Advisory Clinical Pharmacist, Healthcare , Fargo, North Dakota

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