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Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.
We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.
The Senior Clinical Pharmacist will be responsible for leading the pharmacy formularies to ensure appropriate coverage and cost effectiveness.
Principal Duties and Responsibilities:
oServes as the P&T Committee Secretary
oPrepares materials for committee members.
*Annual review of existing utilization management criteria
*Development of new criteria
oCollaborating with the PBM on materials presented to the P&T committee regarding new drug
oParticipates as the Chair of the Drug Coverage Committee
oPrepares materials for distribution to the committee members
oPresents topics at meeting
oAssists in development and implementation of new programs
oMaintains and updates existing programs as clinically appropriate
oDevelops and implements clinical pharmacy strategies which result in high-quality, cost-effective pharmacy management and outcomes
oDevelops, analyzes, reports on clinical programs, handles and coordinates between Pharmacy and other collaborators throughout Mass General Brigham Health Plan.
oDevelops, implements, and leads managed care programs such as prior authorization and quantity limitations programs
oEnsures clinical compliance with law and regulatory bodies
oDevelops educational materials, newsletters, member, and provider talking points and disseminates clinical information for both internal and external audiences.
oRepresents Mass General Brigham Health Plan at the MassHealth DUR Board meeting as needed
oAttends the ACO Pharmacy Workgroup committee
oParticipates in other committees as requested
oWorks with the Clinical Pharmacy Associates to ensure coding is accurate and reflects intent of the plan
oDaily review of formulary issues:
*Override requests
*Correspond with providers about formulary alternatives
oPartners with Care Managers and CMA
oCoordinates with Pharmacy Benefits Manager on processing issues
oWorks with Member Services on pharmacy issues
oImplements of formulary decisions
oPerforms Specialty Pharmacy audits of prior authorization.
Qualifications:
* Pharm D required or the equivalent combination of training and experience, plus 3 years of experience in managed care pharmacy.* Valid Unrestricted Pharmacist License Required.
Skills/Abilities/Competencies:
* Demonstrate Mass General Brigham Health Plans core brand principles of always listening, challenging conventions, and providing value. * Bring fresh ideas forward by listening to and working with employees and the people we serve. * Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner. * Strong, demonstrated track record of an ability to execute on time, on budget, and on scope. * Strong aptitude for technology-based solutions. * Ability to inject energy, when and where it's needed. * Current in healthcare trends.* Demonstrated forward, visionary thinking; ability to see "what is" and envision "what could be."* Ability to develop, introduce, defend, and gain support for a new ideas and approaches. * Excellent leadership skills and leadership track record.* Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required. * Ability to view the long-range trends and cycles of the business and industry and see the "big picture." * Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions.* Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy. * Excellent interpersonal skills, including the ability to influence others at all levels of an organization. * Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.* Unquestionable integrity.
EEO StatementMass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives, and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under the law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment.
Full Time
$166k-188k (estimate)
04/29/2024
05/02/2024