Clinical Pharmacy Program Consultant - Hybrid

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Clinical Pharmacy Program Consultant - Hybrid

Job Number: 2024-46706
Category: Healthcare
Location: North Quincy, MA
Shift: Day
Exempt/Non-Exempt: Exempt
Business Unit: ForHealth Consulting
Department: ForHealth Consulting - Office Of Clinical Affairs - W401300
Job Type: Full-Time
Salary Grade: P3
Union Code: Non Union Position - W60- Non Unit Professional
Num. Openings: 1
Post Date: Sept. 17, 2024

POSITION SUMMARY:

Under the general direction of the Clinical Pharmacy Manager or designee, the Consultant Pharmacist IV functions as a team member of the Pharmacy Program within the Office of Clinical Affairs (OCA). The Consultant Pharmacist IV will assist in the development and management of the MassHealth Drug List, clinical initiatives, Accountable Care Organization pharmacy oversight, and other pharmacy programs. This position will serve as a liaison to EOHHS sister agencies, the Drug Utilization Review Program, pharmacy providers, and the pharmaceutical industry, as necessary.

ESSENTIAL FUNCTIONS:

1. Manage select aspects of the specialty pharmacy program
2. Recommend appropriate therapeutic interchanges based on clinical information, economic evaluations, and strategic initiatives
3. Identify market trends related to specialty pharmacy and proactively recommend adjustments
4. Analyze cost data and make formulary recommendations
5. Analyze data and clinical appropriateness for supplemental rebates and present findings to senior management for action
6. Monitor the clinical program, analyze results, and plan new program initiatives
7. Serve as liaison to the MassHealth Quality Office
8. Participate in the development of clinical drug use criteria for the Pharmacy Program
9. Lead pharmacy strategy workgroups to ensure that deliverables are met and that program or initiative implementation is optimized
10. Evaluate appropriate therapeutic classes for procurement based on utilization and clinical information
11. Evaluate, interpret, and present data in formal written format for review
12. Lead and participate in quality improvement and quality assurance initiatives
13. Refer suspected abuse and fraudulent members to the program manager or designee for case review
14. In the absence of the Pharmacy Manager, make clinical recommendations to sister agencies and other stakeholders
15. Perform other duties as required

REQUIRED QUALIFICATIONS:

1. Bachelor of Science degree in Pharmacy with 3 years of work experience or
   • Doctor of Pharmacy degree with 2 years of pharmacy-related work experience or completion of 2 years of pharmacy residency or
   • Doctor of Pharmacy degree with completion of 1 year of pharmacy residency and 1 year of pharmacy-related work experience or
   • Doctor of Pharmacy degree with completion of managed care residency program
2. Eligibility for licensure or current pharmacist license in good standing in the Commonwealth of Massachusetts
3. Ability to travel to off-site locations

PREFERRED QUALIFICATIONS:

1. Previous medical and medication review experience
2. Bilingual fluency in reading, writing, and speaking English and one other major language
3. Experience with Medicaid
4. Experience with Managed Care
5. Experience in data analysis, and the evaluation and interpretation of economic models