Demo

Pharmacist/Clinical Services Manager

National CooperativeRx
Madison, WI Full Time
POSTED ON 3/5/2026
AVAILABLE BEFORE 5/4/2026
DefinitionNational CooperativeRx seeks a clinical services manager to join our innovative, dynamic, nationwide organization dedicated to helping members control pharmaceutical costs. As a clinical services manager, you will utilize clinical and analytical skills to positively impact the health of members while helping reduce health care costs. This position reports to the Director of Clinical Services. This position is based in Madison, Wisconsin and one day a week in office is required.Qualifications:Graduated from an accredited College or School of Pharmacy with a baccalaureate degree in pharmacy and/or a Doctor of Pharmacy degree and holds an active unrestricted pharmacy license.Strong analytical skills with the ability to present and defend findings.General but functional understanding of a pharmacy benefits manager, employer self-funding and employee benefits.Strong verbal and written communication skills.Ability to solve problems independently and as part of a team.Clinical Responsibilities:Majority of time spent reviewing prior authorizations (PA) and appeals for specialty medication prescriptions.Collaborate with internal and external colleagues on complex cases and conduct peer-to-peer reviews on escalated cases.Provide other clinical services including high dollar claims review for members of the Cooperative.Evaluate, recommend, and monitor PBM clinical criteria.Assist in the creation and implementation of new or updated Cooperative clinical programs.Evaluate and monitor PBM utilization reports and develop internal Cooperative reports as needed.Provide updates to Cooperative staff on drug utilization patterns and trends.Serve as a clinical resource for health plan participants, Cooperative members, and other stakeholders on clinical initiatives and issues.Assist with studies to evaluate clinical programsAssist with development of a variety of Cooperative communication materials, including marketing/educational support materials, newsletter and website content.Research current medical literature and other references as necessary to support Cooperative clinical programs and remain knowledgeable on clinical treatment guidelines and the drug product pipeline.Interested candidates should send a cover letter, resume, and compensation requirements to careers@nationalcooperativerx.com.Company DescriptionHeadquartered in Madison, Wisconsin, National CooperativeRx is a growing, not-for-profit, member-owned cooperative of employers and other organizations. Together, our member-owners leverage their collective purchasing power to access the best discounts and innovative clinical programs from a pharmacy benefit manager (PBM) chosen via a competitive bid process. National CooperativeRx offers a strong compensation and benefits package, as well as a flexible and rewarding environment where employees have the opportunity to make a significant contribution.

Salary : $115,000 - $130,000

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