Clinical Pharmacist

Duties and responsibilities

• Serve as the primary clinical subject matter expert supporting external client interactions, including utilization reviews, strategic discussions, and finalist presentations. Provide ongoing clinical consultation to external clients and internal stakeholders on emerging pharmacy trends, therapeutic advancements, and formulary strategy. Acts as a clinical consultant for internal sales team with the goal of fostering strong partnerships that enhance client value and experience.
• Partner closely with consultant teams to provide a unified, consultative experience for clients, ensuring alignment between clinical pharmacy strategy and account priorities. Assist with development and delivery of client-facing presentations that clearly communicate pharmacy utilization trends, market insights, clinical program performance, pharmacy strategy and strategic recommendations.
• Review and analyze account-specific pharmacy utilization, trend data and overall performance of formularies and/or utilization management to identify opportunities to improve clinical outcomes and cost efficiency. Evaluate the impact of clinical programs and recommend modifications based on performance insights and evolving standards of care. Work collaboratively with vendors, PBMs, accounts, and internal parties for oversight of clinical programs and performance management.
• Participate in the new pharmacy business process including but not limited to serving as a clinical pharmacy resource for review of written RFP responses and presenting at finalist meetings. Contribute clinical expertise to strategic discussions supporting new and existing business opportunities.
• Monitor and synthesize pharmacy market developments, including new drug approvals, pipeline trends, and competitor strategies and translate these market insights into practical recommendations that help inform client strategy and decision-making.
• Provide training and working with offshore pharmacists in helping them build expertise.
• Travel Requirements: 25% - May need to occasionally travel internationally or domestically for client meetings
• Ability to work independently, as well as a member of a team.
• Strong critical reasoning skills in clinical decision-making, planning and organizing.
• Current knowledge of clinical practices and related UM systems, information systems, and computer applications.
• A strong balance between clinical expertise and business acumen.
• Strong interpersonal, written and verbal communication skills, including presentation skills.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be challenging.
• Doctor of Pharmacy (PharmD) Or Master’s Degree in Pharmacy for Registered Pharmacist (RPh).
• PharmD - Licensed Pharmacist or Active Registered Pharmacist in any state.
• 8-10 years’ experience in clinical pharmacy, preferably in a managed care environment (PBM or health plan), and clinical consulting/sales environment with good knowledge of emerging Pharma markets (Such as high-cost drug management, etc.)
• Deep experience working in healthcare industry with a thorough understanding of prescription benefit management programs and practices.
• Have experience working on multiple different Prior auth workflow systems
• Experience in account management/sales showcasing expertise in Part D and Part B drugs.
• Knowledge of Medicare Advantage, Medicare, Commercial, Marketplace, and Medicaid lines of business.

Skills & competencies

Minimum education and experience required

Preferred Qualifications

• Demonstrated experience in clinical research, technical writing and publishing, a clinical specialty, claims management or health care policy.
• Basic understanding of software development phases/life cycles.
• Project management skills.
• Six Sigma skills.
• Knowledge of NCQA and URAC accreditation
• Sagility is an Equal Opportunity Employer/Vet/Disability.
• Work@Home USAUnited States of America

Location:

• Work@Home USAUnited States of America