Clinical Pharmacist
Apply NowCompany: Health and Human Services Commission of Texas
Location: Austin, TX 78745
Description:
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Clinical Pharmacist
Job Title: Pharmacist I
Agency: Health & Human Services Comm
Department: Pharmacy Benefits Mgmt SPMP
Posting Number: 4562
Closing Date: 05/07/2025
Posting Audience: Internal and External
Occupational Category: Healthcare Practitioners and Technical
Salary Group: TEXAS-B-27
Salary Range: $7,015.16 - $11,864.50
Shift: Day
Additional Shift:
Telework:
Travel: Up to 5%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Exempt
Facility Location:
Job Location City: AUSTIN
Job Location Address: 701 W 51ST ST
Other Locations:
MOS Codes:
230X,43PX,67E,SEI12
Brief Job Description:
The position reports to the Pharmacist Director of DUR Formulary Management. The pharmacist I works under minimal supervision with considerable latitude for the use of initiative and independent judgment. Responsible for coordination and maintenance of the Vendor Drug Formulary files including non-drug products and vaccines, Preferred Drug List (PDL) program, and Drug Use Review (DUR) program (which helps ensure appropriate clinical use of medications in the out-patient setting). Participate in the weekly clinical review and assessment of new to market drugs as a clinical pharmacist with the PDL and formulary vendor. Performs consultative and technical work related to the prescription drug programs for Medicaid, Kidney Health Care (KHC), Children with Special Health Care Needs (CSHCN), and the Children's' Health Insurance Program (CHIP). Work involves planning, developing, and implementing policies and procedures for prescription drug programs consistent with federal and state laws and regulations, conducting analysis of complex pharmaceutical policy issues. Provides pharmaceutical consultative services to HHSC staff, other government agencies, pharmacy providers, pharmaceutical industry representatives and their agencies, and stakeholder groups. The position provides prescription outpatient claim processing and payment functions, as well as formulary management. The pharmacist I will prepare the Drug Utilization Review (DUR) annual report for Centers for Medicare & Medicaid Services (CMS); oversees the design and analysis of utilization reports; creates and analyzes ad hoc utilization reports; and participates in on-line claims adjudication system enhancements, and prospective DUR edits. Assists in the administration and coordination of Medicaid, CHIP, KHC, and CSHCN prior authorization and prospective DUR programs. Coordinates DUR activities with contracted entities and will participate in DUR Board activities. Functions as a liaison between contracted entities with Medicaid and CHIP contract groups, other agency areas, professional organizations, and other state agency pharmacy personnel. The position provides assistance in preparation of criteria and standards utilized in the DUR process; assists as a hearing officer for the pharmacy appeals process. Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties/special projects as assigned by the Pharmacist Director.
Essential Job Functions (EJFs):
(25%) Manages the State Preferred Drug List (PDL) Program and Drug Use Review Program. Reviews, research, and develops prior authorization drug use criteria. Ensures the PDL promotes the use of safe, efficacious, and cost-effective drugs. Reviews and analyzes drug utilization patterns and evaluates the impact of the PDL on overall drug utilization. Initiates, plans, and develops activities of the federally required Drug Use Review Board to include both retrospective and prospective drug utilization review and educational intervention strategies for physicians, pharmacists, and other health care professionals as well as program analysis. Approves new single-source drugs to the Vendor Program formulary. Evaluates therapeutic appropriateness for outpatient usage, establishes maximum allowable quantity limits and prescribing edits. Monitors the timely adjustment of drug pricing and information updates per published notification.
(20%) Manage, and maintain the VDP drug formularies for the Medicaid, CHIP, CSHCN, and KHC programs. Lead or participate in the weekly clinical review and assessment of drugs as the designated subject matter expert (SME) with the pharmacy vendor. Coordinates with staff from CSHCN, KHC, and CHIP to ensure that prior approval criteria and methodologies are consistent within programs. Performs, and reviews the research of pharmaceutical compendia and various pharmaceutical industry market informational resources regarding the clinical efficacy and safety of pharmaceutical products and their appropriate formulary coverage, pricing, and/or limitations for improved program economics, client services, and appropriate use in the Medicaid and CHIP programs. Provides technical pharmaceutical information on issues related to appropriate prescription drug use and prior approval criteria. Coordinates with contracted entities to ensure appropriate application of criteria and standards and assists in the development of educational intervention strategies.
(20%) Analyzes, prepares, and interprets management reports and on-line claim data using available data from the pharmacy operations vendor with knowledge of pharmacy practice and Vendor Drug Program policies. Oversees the design and analysis of utilization reports.
(10%) Serves as a subject matter expert (SME) on assigned projects or specific subject area(s) to ensure accuracy, compliance, meeting deadlines, and project completion.
(10%) Provides data, research and assessment, technical assistance, litigation support, and expert witness testimony to the Texas Attorney General's office, the Federal Office of the Inspector General, and other state Attorney General offices on topics and matters relating to litigation and ongoing investigations involving pharmaceutical manufacturer drug pricing and marketing practices.
(15%) Assists the Director in planning and overseeing daily operations for the DUR Formulary area. Keeps the Director apprised of pertinent issues. Serves as resource for the pharmacy operations vendor. Performs related duties as assigned or required.
Knowledge, Skills and Abilities (KSAs):
Knowledge of: extensive practice of pharmacy and motivation to continue learning about changes in the pharmaceutical industry. Extensive State and Federal laws and regulations governing the practice of pharmacy. Extensive Pharmacy Benefits Management in a managed care service delivery model. Administrative policies, processes, standards, procedures, regulations, and laws pertaining to Medicaid and CHIP outpatient drug programs.
Skilled in: strong interpersonal skills in order to interact with a variety of contacts courteously, professionally, and tactfully. Problem solving and reasoning skills to interpret and apply Federal and State policies, pharmacy laws and rules, and to recommend courses of action.
Ability to: communicate clearly, verbally and in writing. Deal with professionals in the medical and various pharmaceutical fields under adversarial conditions. Organize and oversee projects to completion and to meet deadlines. Work cooperatively as a team member in a rapid-paced, deadline-oriented environment. Research, evaluate, and develop policies and procedures that will result in clinically sound and medically appropriate drug therapies.
Registrations, Licensure Requirements or Certifications:
The applicant must have a current license to practice pharmacy in Texas. In addition, the license must be in good standing with the Texas State Board of Pharmacy.
Initial Screening Criteria:
Graduation from an ACPE accredited School or College of Pharmacy with a Bachelor's, or Doctor of Pharmacy (PharmD). (Required)
The applicant must possess a current license to practice pharmacy in Texas. In addition, the license must be in good standing with the Texas State Board of Pharmacy and with any other state the candidate is licensed in. (Required)
Managed care pharmacy experience. (Preferred)
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, and Veterans:
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor's Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA Accommodations:
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
Pre-Employment Checks and Work Eligibility:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Telework Disclaimer:
This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.
Functional Title: Clinical Pharmacist
Job Title: Pharmacist I
Agency: Health & Human Services Comm
Department: Pharmacy Benefits Mgmt SPMP
Posting Number: 4562
Closing Date: 05/07/2025
Posting Audience: Internal and External
Occupational Category: Healthcare Practitioners and Technical
Salary Group: TEXAS-B-27
Salary Range: $7,015.16 - $11,864.50
Shift: Day
Additional Shift:
Telework:
Travel: Up to 5%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Exempt
Facility Location:
Job Location City: AUSTIN
Job Location Address: 701 W 51ST ST
Other Locations:
MOS Codes:
230X,43PX,67E,SEI12
Brief Job Description:
The position reports to the Pharmacist Director of DUR Formulary Management. The pharmacist I works under minimal supervision with considerable latitude for the use of initiative and independent judgment. Responsible for coordination and maintenance of the Vendor Drug Formulary files including non-drug products and vaccines, Preferred Drug List (PDL) program, and Drug Use Review (DUR) program (which helps ensure appropriate clinical use of medications in the out-patient setting). Participate in the weekly clinical review and assessment of new to market drugs as a clinical pharmacist with the PDL and formulary vendor. Performs consultative and technical work related to the prescription drug programs for Medicaid, Kidney Health Care (KHC), Children with Special Health Care Needs (CSHCN), and the Children's' Health Insurance Program (CHIP). Work involves planning, developing, and implementing policies and procedures for prescription drug programs consistent with federal and state laws and regulations, conducting analysis of complex pharmaceutical policy issues. Provides pharmaceutical consultative services to HHSC staff, other government agencies, pharmacy providers, pharmaceutical industry representatives and their agencies, and stakeholder groups. The position provides prescription outpatient claim processing and payment functions, as well as formulary management. The pharmacist I will prepare the Drug Utilization Review (DUR) annual report for Centers for Medicare & Medicaid Services (CMS); oversees the design and analysis of utilization reports; creates and analyzes ad hoc utilization reports; and participates in on-line claims adjudication system enhancements, and prospective DUR edits. Assists in the administration and coordination of Medicaid, CHIP, KHC, and CSHCN prior authorization and prospective DUR programs. Coordinates DUR activities with contracted entities and will participate in DUR Board activities. Functions as a liaison between contracted entities with Medicaid and CHIP contract groups, other agency areas, professional organizations, and other state agency pharmacy personnel. The position provides assistance in preparation of criteria and standards utilized in the DUR process; assists as a hearing officer for the pharmacy appeals process. Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties/special projects as assigned by the Pharmacist Director.
Essential Job Functions (EJFs):
(25%) Manages the State Preferred Drug List (PDL) Program and Drug Use Review Program. Reviews, research, and develops prior authorization drug use criteria. Ensures the PDL promotes the use of safe, efficacious, and cost-effective drugs. Reviews and analyzes drug utilization patterns and evaluates the impact of the PDL on overall drug utilization. Initiates, plans, and develops activities of the federally required Drug Use Review Board to include both retrospective and prospective drug utilization review and educational intervention strategies for physicians, pharmacists, and other health care professionals as well as program analysis. Approves new single-source drugs to the Vendor Program formulary. Evaluates therapeutic appropriateness for outpatient usage, establishes maximum allowable quantity limits and prescribing edits. Monitors the timely adjustment of drug pricing and information updates per published notification.
(20%) Manage, and maintain the VDP drug formularies for the Medicaid, CHIP, CSHCN, and KHC programs. Lead or participate in the weekly clinical review and assessment of drugs as the designated subject matter expert (SME) with the pharmacy vendor. Coordinates with staff from CSHCN, KHC, and CHIP to ensure that prior approval criteria and methodologies are consistent within programs. Performs, and reviews the research of pharmaceutical compendia and various pharmaceutical industry market informational resources regarding the clinical efficacy and safety of pharmaceutical products and their appropriate formulary coverage, pricing, and/or limitations for improved program economics, client services, and appropriate use in the Medicaid and CHIP programs. Provides technical pharmaceutical information on issues related to appropriate prescription drug use and prior approval criteria. Coordinates with contracted entities to ensure appropriate application of criteria and standards and assists in the development of educational intervention strategies.
(20%) Analyzes, prepares, and interprets management reports and on-line claim data using available data from the pharmacy operations vendor with knowledge of pharmacy practice and Vendor Drug Program policies. Oversees the design and analysis of utilization reports.
(10%) Serves as a subject matter expert (SME) on assigned projects or specific subject area(s) to ensure accuracy, compliance, meeting deadlines, and project completion.
(10%) Provides data, research and assessment, technical assistance, litigation support, and expert witness testimony to the Texas Attorney General's office, the Federal Office of the Inspector General, and other state Attorney General offices on topics and matters relating to litigation and ongoing investigations involving pharmaceutical manufacturer drug pricing and marketing practices.
(15%) Assists the Director in planning and overseeing daily operations for the DUR Formulary area. Keeps the Director apprised of pertinent issues. Serves as resource for the pharmacy operations vendor. Performs related duties as assigned or required.
Knowledge, Skills and Abilities (KSAs):
Knowledge of: extensive practice of pharmacy and motivation to continue learning about changes in the pharmaceutical industry. Extensive State and Federal laws and regulations governing the practice of pharmacy. Extensive Pharmacy Benefits Management in a managed care service delivery model. Administrative policies, processes, standards, procedures, regulations, and laws pertaining to Medicaid and CHIP outpatient drug programs.
Skilled in: strong interpersonal skills in order to interact with a variety of contacts courteously, professionally, and tactfully. Problem solving and reasoning skills to interpret and apply Federal and State policies, pharmacy laws and rules, and to recommend courses of action.
Ability to: communicate clearly, verbally and in writing. Deal with professionals in the medical and various pharmaceutical fields under adversarial conditions. Organize and oversee projects to completion and to meet deadlines. Work cooperatively as a team member in a rapid-paced, deadline-oriented environment. Research, evaluate, and develop policies and procedures that will result in clinically sound and medically appropriate drug therapies.
Registrations, Licensure Requirements or Certifications:
The applicant must have a current license to practice pharmacy in Texas. In addition, the license must be in good standing with the Texas State Board of Pharmacy.
Initial Screening Criteria:
Graduation from an ACPE accredited School or College of Pharmacy with a Bachelor's, or Doctor of Pharmacy (PharmD). (Required)
The applicant must possess a current license to practice pharmacy in Texas. In addition, the license must be in good standing with the Texas State Board of Pharmacy and with any other state the candidate is licensed in. (Required)
Managed care pharmacy experience. (Preferred)
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, and Veterans:
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor's Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA Accommodations:
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
Pre-Employment Checks and Work Eligibility:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Telework Disclaimer:
This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.