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Job ID: 7288
Location: Morrisville, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
The University of North Carolina Health Care System (UNCHCS) has an opening for a highly motivated individual interested in joining our team to develop and implement PBM programs and services including formulary and drug utilization management services. The PBM Pharmacist will provide daily support for all PBM operational tasks as it relates to covered health plans. Specifically, the PBM Pharmacist will develop formulary and drug utilization management strategies that will be implemented for multiple types of patient populations. The PBM Pharmacist will create benefit designs that lead to optimal clinical outcomes while leveraging 340B eligibility, pharmacy purchase agreements and other means to achieve the most cost effective options. The PBM Pharmacist will prepare key discussion points for UNC Health System’s P&T formulary subcommittee. The PBM Pharmacist will track and evaluate drug utilization and spend on a monthly basis. The PBM Pharmacist will recommend and implement pharmacy benefit changes that will improve adherence and clinical outcomes, address inappropriate utilization and optimize drug spend.
• Develop and implement formularies in conjunction with drug utilization management and clinical programs that serve multiple patient populations.
• Work collaboratively to align UNCHCS formularies when feasible.
• Develop and maintain member and physician facing materials to support the use of the formularies and drug utilization management programs.
• Collaborate with the claims adjudicator to ensure all formularies, clinical edits and plan designs are implemented according to requirements.
• Oversee completion of prior authorization requests for members through collaboration with Prior Authorization Specialists and the claims adjudicator.
• Utilize pharmacy and medical claims data to evaluate and implement solutions to address inappropriate utilization, improve outcomes and optimize drug spend.
• Respond to and resolve pharmacy-related inquiries from members, clients, providers, or pharmacies related to formulary options, therapeutic alternatives, and Prior Authorization determinations for covered health plans.
• Collaborate with the UNCHS Shared Services Pharmacy and outpatient pharmacies to develop programs and services that maximize the use of internal pharmacies.
• Complete other projects and initiatives as assigned.
REQUIRED SKILLS AND ATTRIBUTES
The PBM Pharmacist should demonstrate the following skills and attributes:
• Strong leadership skills.
• Excellent communication skills.
• Strong organizational and time management skills.
• Ability to work collaboratively and independently.
• Perform effectively in cross-functional groups.
• Ability to lead projects and meet critical deadlines.
QUALIFICATIONS & REQUIRED EXPERIENCE
• Doctor of Pharmacy Degree from an accredited college or university or equivalent work experience.
• Licensure or license-eligibility as Pharmacist in the state of North Carolina.
• Greater than 3 years of broad PBM and managed care experience.
• Completion of an ASHP-accredited Pharmacy Practice Residency or appropriate professional experience.
• Completion of managed care residency is strongly preferred or appropriate professional experience.
The Pharmacy Benefit Management (PBM) Pharmacist will report to the Manager of PBM Services.
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: HCS Pharmacy Benefit Mgt
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Morrisville
Exempt From Overtime: Exempt: Yes
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.