Clinical Pharmacist - Medicare Advantage

Company Description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! 

Learn more about our unique benefit offerings here. 

Want to know more? You can learn about life at Wellmark here.

Job Description

Bring your strengths to Wellmark as a Clinical Pharmacist – Medicare Advantage on a growing Pharmacy team! 

About the role: As a Clinical Pharmacist focused on Medicare Advantage (MA) support, you'll be responsible for supporting the management of Wellmark’s clinical strategies to strengthen Wellmark Medical and Pharmacy Drug Programs. You will serve as a drug information and clinical resource for Wellmark’s MA provider network team, vendors and joint venture partners to support Medicare Stars ratings and total cost of care. In collaboration with the Health and Pharmacy Services team and other Wellmark stakeholders, you will be responsible for the development and maintenance of evidence-based policies, clinical drug programs, and formulary management to improve quality and affordability outcomes within Wellmark’s MA program.  

About you: You have diverse clinical pharmacy experience and are excited about the opportunity to bring your skills to a health plan!  

You are passionate about positively impacting the health care system and doing what is right for our members. You are highly collaborative by nature and feel teamwork is essential for success. While you are skilled in collaborating with various stakeholders, you are also a self-starter and appreciate the balance of working autonomously to reach a goal. You are curious and thrive when you can use evidence-based research to drive decisions. You have strong consultation and communication skills that lead you to excel in partnering with the right people to develop creative solutions. You aren’t afraid to present insights to various audiences and are skilled in adapting your communication approach. You are experienced in clinical appeal reviews and communicating actionable insights of your reviews. You aren’t afraid to learn and take on something new – this excites you! Top candidates will have managed-care pharmacy experience and/or Medicare Advantage experience, with knowledge of CMS measures and MA regulations. 

If this sounds like you, consider applying to our Clinical Pharmacist - Medicare Advantage opening today! 

This position will work a hybrid schedule of at least 3 days in a Wellmark office, with 2 days remote option.  

Qualifications

Required Education:  Bachelor's Degree in Pharmacy OR PharmD

Required Licensure:  An active and unrestricted Pharmacy license in Iowa or South Dakota (individual must be licensed in the state in which they reside) is required within 6 months from date of hire.

Additional Required Qualifications:

• 3+ years of managed care pharmacy or pharmacy residency program experience. Broad understanding of the health care delivery system, managed care and pharmacy benefit management systems, plan design and overall operations.
• Ability to make effective evidence-based decisions. Strong analytical, problem solving, and critical thinking skills.
• Excellent written and verbal communication skills. Ability to effectively articulate complex information across all levels of an organization. Strong presentation skills.
• Strong consulting and interpersonal skills to quickly build rapport, credibility, and collaborative partnerships with clinical peers, leaders, and stakeholders.
• Proficient in Microsoft Office & intermediate Excel skills – e.g., pivot tables, trend analysis, formulas.
• Strong knowledge of applicable rules, regulations, and guidelines, and maintain awareness of implications to pharmacy.
• Strong organization and prioritization skills. Ability to manage multiple projects simultaneously and consistently meet deadlines.
• Self-starter who can work well independently and as a member of a cross-functional team. Proven ability to work collaboratively with others.
• Requires Active and Unrestricted Pharmacy License in a state within the United States

Preferred Qualifications:

• Coaching/mentoring experience.
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