Senior Formulary Specialist
Apply NowCompany: CGC Group Inc.
Location: New York, NY 10025
Description:
Job title: Senior Formulary Specialist
Location: Remote, CST or EST required
Duration: Assignment
**Must hold NY Pharmacy license**
Summary of Position:
Responsible for development, implementation, and maintenance of preferred formulary drug lists.
Responsible for preferred drug lists for key clinical areas including primary care, pediatrics, dermatology, cardiology, ophthalmology, rheumatology, hematology/oncology, gastroenterology.
Responsible for development and maintenance activities for formularies for one or more of the following lines of business: Medicare Part D, Medicaid, Commercial, Healthcare Exchange.
Use sound clinical judgment and knowledge of State and Federal regulations to ensure compliance with regulatory and contractual obligations.
Principal Accountabilities:
Develop preferred formulary drug lists across all lines of business: Medicare Part D, Medicaid, Commercial, Healthcare Exchange.
Evaluate and maintain formulary set-up based on clinical requirements, compliance with regulatory bodies, and P&T rules.
Maintain clinical tools utilized by pharmacy services for purpose of remaining up to date and compliant with current pharmacy policies.
Provide education on new formulary updates including quarterly formulary changes and annual 1/1 changes.
Serve as subject matter expert for all escalated clinical formulary related issues as well as for all formulary related internal and external audits.
Review weekly reports to identify trends and compliance.
Work with IT to maintain preferred drug list updates.
Identify and target prescribing outliers.
Work with actuary to determine cost saving alternatives for preferred drug list.
Manage the Pharmacy & Therapeutic Committee/Formulary Management, including Step-Protocol Review, NonFormulary Review, Subcommittee Management (Meetings/minutes), Drug Reviews, and Updates and Drug Policies, for all medications.
Report formulary compliance to senior leadership.
NOTE: This description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities, and may be changed at any time with or without notice.
Other duties/projects as assigned
Education, Training, Licenses, Certifications:
Doctor of Pharmacy degree
PGY-1 or PGY-2 In Ambulatory Care, Geriatrics, Internal Medicine, or Managed Care Preferred
Registered Pharmacist: New York State pharmacy license or eligible to obtain New York State license within 6 months
Relevant Work Experience, Knowledge, Skills, and Abilities:
A minimum of 10 years of relevant experience. (R)
Residency or 5 years' clinical experience preferred (P)
Knowledge of formulary utilization management techniques (R)
Knowledge of pharmaceuticals and disease states to provide advice and consultation to providers and members, and recommend changes to the formulary (R)
Possess research and analytical skills sufficient to provide problem resolution and consultation to providers (R)
Excellent verbal and written communication skills sufficient to prepare own correspondence and interact with members and providers in provision of advice and guidelines (R)
The pay for this role is $65-$75 an hour DOE.
Benefits through CGC: Dental, Vision, STD and/or LTD, Voluntary Life & AD&D, Accident, Critical Illness, Hospital Indemnity, Health Advocate EAP, and Health Equity Commuter Benefits, ZayZoon, and 401k.
We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws
Location: Remote, CST or EST required
Duration: Assignment
**Must hold NY Pharmacy license**
Summary of Position:
Responsible for development, implementation, and maintenance of preferred formulary drug lists.
Responsible for preferred drug lists for key clinical areas including primary care, pediatrics, dermatology, cardiology, ophthalmology, rheumatology, hematology/oncology, gastroenterology.
Responsible for development and maintenance activities for formularies for one or more of the following lines of business: Medicare Part D, Medicaid, Commercial, Healthcare Exchange.
Use sound clinical judgment and knowledge of State and Federal regulations to ensure compliance with regulatory and contractual obligations.
Principal Accountabilities:
Develop preferred formulary drug lists across all lines of business: Medicare Part D, Medicaid, Commercial, Healthcare Exchange.
Evaluate and maintain formulary set-up based on clinical requirements, compliance with regulatory bodies, and P&T rules.
Maintain clinical tools utilized by pharmacy services for purpose of remaining up to date and compliant with current pharmacy policies.
Provide education on new formulary updates including quarterly formulary changes and annual 1/1 changes.
Serve as subject matter expert for all escalated clinical formulary related issues as well as for all formulary related internal and external audits.
Review weekly reports to identify trends and compliance.
Work with IT to maintain preferred drug list updates.
Identify and target prescribing outliers.
Work with actuary to determine cost saving alternatives for preferred drug list.
Manage the Pharmacy & Therapeutic Committee/Formulary Management, including Step-Protocol Review, NonFormulary Review, Subcommittee Management (Meetings/minutes), Drug Reviews, and Updates and Drug Policies, for all medications.
Report formulary compliance to senior leadership.
NOTE: This description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities, and may be changed at any time with or without notice.
Other duties/projects as assigned
Education, Training, Licenses, Certifications:
Doctor of Pharmacy degree
PGY-1 or PGY-2 In Ambulatory Care, Geriatrics, Internal Medicine, or Managed Care Preferred
Registered Pharmacist: New York State pharmacy license or eligible to obtain New York State license within 6 months
Relevant Work Experience, Knowledge, Skills, and Abilities:
A minimum of 10 years of relevant experience. (R)
Residency or 5 years' clinical experience preferred (P)
Knowledge of formulary utilization management techniques (R)
Knowledge of pharmaceuticals and disease states to provide advice and consultation to providers and members, and recommend changes to the formulary (R)
Possess research and analytical skills sufficient to provide problem resolution and consultation to providers (R)
Excellent verbal and written communication skills sufficient to prepare own correspondence and interact with members and providers in provision of advice and guidelines (R)
The pay for this role is $65-$75 an hour DOE.
Benefits through CGC: Dental, Vision, STD and/or LTD, Voluntary Life & AD&D, Accident, Critical Illness, Hospital Indemnity, Health Advocate EAP, and Health Equity Commuter Benefits, ZayZoon, and 401k.
We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws