Clinical Pharmacist - Formulary

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As a Clinical Pharmacist, you will play a pivotal role in developing, implementing, and managing formulary strategies that ensure clinically appropriate and cost-effective medication use. This role supports Premera’s clinical and financial goals by collaborating across departments and with external stakeholders to optimize formulary design, utilization management, and strategic pharmacy initiatives.

What you will do:

• Develop and manage formulary strategies, including tier placement, exclusions, and preferred drug selections using pharmacoeconomic and utilization data.
• Collaborate on RFPs, client consulting, and other functional areas to ensure clinical criteria are embedded in contracting processes.
• Partner with PBM partners on rebate strategy and coding, and with actuarial and clinical operations teams to assess rebate opportunities and model financial impacts of formulary decisions.
• Provide leadership and support for the P&T Committee, including implementing strategic changes in service of broader formulary and departmental long-term plans. Drive formulary updates and maintenance across multiple lines of business, ensuring strategic alignment, regulatory compliance, and cost-effective, clinically sound drug coverage decisions.
• Continuously review and adapt to regulatory and accreditation requirements (ACA, WA OIC, AK DOI, NCQA, HEDIS). Support medical management and clinical pharmacy initiatives through research, analyses, and administration of clinical drug utilization management programs.
• Assist in administering Pharmacy Prior Authorization and other clinical pharmacy programs. Identify and help resolve drug-related issues in collaboration with medical services staff to optimize medication therapy and improve clinical outcomes.
• Develop and maintain provider and member communication materials that support clinical pharmacy programs.
• Serve as a preceptor for pharmacy students and/or residents, introducing them to drug utilization management, care management activities, product review, and program development.

What you will bring:

• Pharmacist Degree.
• Active US Pharmacist license in good standing.
• Clinical pharmacy training, clinical residency training from an accredited Pharmacy program.
• Two years’ experience as a pharmacist.

Additional preferred skills/experiences include:

• An advanced degree (e.g., PharmD, MBA, MHA, MPH, or equivalent experience).
• Managed care setting experience for greater than 5 years.
• Experience in formulary management, rebate negotiations, and decisions.
• Experience with Health Benefit Exchanges and in leading Pharmacy and Therapeutic Committees.

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