Position Summary:

The PGY1 Managed Care Resident helps to ensure safe and cost-effective medication therapy for our members, supports initiatives to maintain the drug benefit for commercial, Medicare, Medicaid, and health insurance marketplace clients, and plays an active role in the development and maintenance of formularies and clinical programs as part of their learning experience.

Position Responsibilities:

• Support initiatives to maintain the drug benefit for commercial, Medicare, Medicaid, and health insurance marketplace clients
• Play an active role in the development and maintenance of formularies for multiple lines of business
• Analyze pharmacy cost of care, trends, and coordinate the development of appropriate utilization management edits including step therapy, prior authorization, and quantity limits
• Design pharmacy benefits for populations of patients based on client-specific elections
• Create pharmaceutical pipeline newsletters / publications / presentations
• Provide clinical resource including support of the prior authorization unit and clinical call center
• Analyze utilization data and creates reports for group plan sponsors (i.e., employers, labor unions, etc.)
• Participate in the development and maintenance of clinical programs such as drug utilization review, medication therapy management, adherence, and disease management programs
• Evaluate industry data to improve existing clinical programs and make recommendations with a focus on clinical offerings and value proposition
• Support the clinical client management team, as needed
• Observe and participate in committee activities related to the pharmacy program
• Design, manage, and complete a clinical residency project for presentation at a conference with the intent to publish research findings
• Supervise pharmacy students and further develop the student program, including coordination with preceptors as needed
• Support quality improvement projects, as needed
• Support request for information and request for proposal submissions, as needed
• Support general business needs and operations, as required
• All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Minimum Qualifications:

• Doctor of Pharmacy (PharmD) Degree from an accredited School of Pharmacy completed prior to start of residency program
• Strong academic performance with a minimum of 2.8 GPA and successful completion of all APPE rotations
• Licensed Pharmacist or eligible for licensure (must be licensed by September 30th of the residency year)
• Proficient in Microsoft office Suite with emphasis on Microsoft Excel
• Ability to balance multiple complex projects simultaneously
• Excellent communication and interpersonal skills, and ability to work with team members, executive management, and business partners in a polished and professional manner
• Ability to work independently, virtually, and in a team environment to produce solutions from concept to final deliverables required
• Familiarity working with large data sets
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, and able to shift priorities easily
• Attention to detail and commitment to delivering high quality work product

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.