Cambia Health Solutions, Inc.
Clinical Pharmacist Consultant
Cambia Health Solutions, Inc., Washington, District of Columbia, us, 20022
**Build a career with purpose. Join our**
**to create a person-focused and economically sustainable health care system.** Every day, Cambia’s dedicated team of Pharmacy Consultants are living our mission to make health care easier and lives better. As a member of the Pharmacy Services team, our Clinical Pharmacist Consultants provide professional and clinical pharmacy expertise in making or guiding clinical decisions based on best practices by creating and applying evidence-based medicine evaluations to determine the best quality medication choices that represent the best value in efficacy, safety and affordability. This may include providing coverage recommendations for medications subject to prior authorization based on applicable medication coverage policies and member benefit contracts or serving as a resource for other staff. This role may also assist in planning, developing, and implementing clinical strategies with respect to formulary management, drug utilization management, and peer-to-peer conversations.
Additional responsibilities may include development of position papers, medication coverage policies, formulary monographs and class reviews, cross-functional projects, and/or initiatives related to the provision of pharmacy benefits that impact safety, quality and affordability – all in service of creating a person-focused health care experience.* Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) or related field* Minimum 3-5 years of experience in clinical acute care/hospital setting or equivalent combination of education and experience* Pharmacy license. Successful completion of a pharmacy residency or advanced degree in health-related field preferred. Must be an active and unrestricted licensed pharmacist in state of practice**Skills and Attributes:** * Strong clinical pharmacy background with ability to demonstrate clinical therapy skills and knowledge in a clinical care setting.* Excellent verbal and written communication skills; strong business analytical skills and abilities; strong project management and coordination ability.* Ability to work independently, to prioritize work, meet deadlines and achieve operational goals* Demonstrated success in managing professional relationships in a managed care system, medical group, hospital, or related organizations.* Ability to collaborate as part of cross functional teams, to improve clinical programs, enhance processes and share clinical information.* Knowledge of pharmaceutical products, including orals, injectables, infusion products, and chemotherapy; state and federal laws and rules regarding the practice of pharmacy and regulation of health care industry practices, such as DOLI, PPACA and HIPAA.* Strong knowledge of health care economics and financing; health care/pharmaceutical industry dynamics; and pharmacy/provider service reimbursement of medications.* Knowledge of Health Plan and benefit design structures and application; Medicare/CMS regulations and applicability in administering the Medicare Product; health care coding and payment systems (such as ICD-9, CPT, HCPCS, NDC).* Strong knowledge of compliance related activities, legislative and regulatory activities, health insurance operations, and legal issues.The expected hiring range for a Clinical Pharmacist Consultant is $120,700 - $163,300 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $113,000 - $185,000. The expected hiring range for a Clinical Pharmacist Consultant Sr. is $134,300 - $181,700 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 20%. The current full salary range for this role is $126,000 - $206,000. * Work alongside diverse teams building cutting-edge solutions to transform health care.* Earn a competitive salary and enjoy generous benefits while doing work that changes lives.* Grow your career with a company committed to helping you succeed.* Give back to your community by participating in Cambia-supported outreach programs.* Connect with colleagues who share similar interests and backgrounds through our employee resource groups.* Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.* Annual employer contribution to a health savings account.* Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.* Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).* Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).* Award-winning wellness programs that reward you for participation.* Employee Assistance Fund for those in need.* Commute and parking benefits.Everyone is a health care consumer deserving of a simpler, more personalized experience.
is transforming the health care system to revolve around people. For over 100 years we’ve designed people-first health solutions rooted in the nation’s first health plan, a loggers’ wage pool established in the Pacific Northwest. Today that pioneering spirit aligns our family of over 20 companies, including 4 not-for-profit
serving over 3 million Americans.Cambia blends data science with a compassionate human perspective to anticipate people’s needs, and empower them to make smarter health care choices..### *Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .* #J-18808-Ljbffr
**to create a person-focused and economically sustainable health care system.** Every day, Cambia’s dedicated team of Pharmacy Consultants are living our mission to make health care easier and lives better. As a member of the Pharmacy Services team, our Clinical Pharmacist Consultants provide professional and clinical pharmacy expertise in making or guiding clinical decisions based on best practices by creating and applying evidence-based medicine evaluations to determine the best quality medication choices that represent the best value in efficacy, safety and affordability. This may include providing coverage recommendations for medications subject to prior authorization based on applicable medication coverage policies and member benefit contracts or serving as a resource for other staff. This role may also assist in planning, developing, and implementing clinical strategies with respect to formulary management, drug utilization management, and peer-to-peer conversations.
Additional responsibilities may include development of position papers, medication coverage policies, formulary monographs and class reviews, cross-functional projects, and/or initiatives related to the provision of pharmacy benefits that impact safety, quality and affordability – all in service of creating a person-focused health care experience.* Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) or related field* Minimum 3-5 years of experience in clinical acute care/hospital setting or equivalent combination of education and experience* Pharmacy license. Successful completion of a pharmacy residency or advanced degree in health-related field preferred. Must be an active and unrestricted licensed pharmacist in state of practice**Skills and Attributes:** * Strong clinical pharmacy background with ability to demonstrate clinical therapy skills and knowledge in a clinical care setting.* Excellent verbal and written communication skills; strong business analytical skills and abilities; strong project management and coordination ability.* Ability to work independently, to prioritize work, meet deadlines and achieve operational goals* Demonstrated success in managing professional relationships in a managed care system, medical group, hospital, or related organizations.* Ability to collaborate as part of cross functional teams, to improve clinical programs, enhance processes and share clinical information.* Knowledge of pharmaceutical products, including orals, injectables, infusion products, and chemotherapy; state and federal laws and rules regarding the practice of pharmacy and regulation of health care industry practices, such as DOLI, PPACA and HIPAA.* Strong knowledge of health care economics and financing; health care/pharmaceutical industry dynamics; and pharmacy/provider service reimbursement of medications.* Knowledge of Health Plan and benefit design structures and application; Medicare/CMS regulations and applicability in administering the Medicare Product; health care coding and payment systems (such as ICD-9, CPT, HCPCS, NDC).* Strong knowledge of compliance related activities, legislative and regulatory activities, health insurance operations, and legal issues.The expected hiring range for a Clinical Pharmacist Consultant is $120,700 - $163,300 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $113,000 - $185,000. The expected hiring range for a Clinical Pharmacist Consultant Sr. is $134,300 - $181,700 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 20%. The current full salary range for this role is $126,000 - $206,000. * Work alongside diverse teams building cutting-edge solutions to transform health care.* Earn a competitive salary and enjoy generous benefits while doing work that changes lives.* Grow your career with a company committed to helping you succeed.* Give back to your community by participating in Cambia-supported outreach programs.* Connect with colleagues who share similar interests and backgrounds through our employee resource groups.* Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.* Annual employer contribution to a health savings account.* Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.* Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).* Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).* Award-winning wellness programs that reward you for participation.* Employee Assistance Fund for those in need.* Commute and parking benefits.Everyone is a health care consumer deserving of a simpler, more personalized experience.
is transforming the health care system to revolve around people. For over 100 years we’ve designed people-first health solutions rooted in the nation’s first health plan, a loggers’ wage pool established in the Pacific Northwest. Today that pioneering spirit aligns our family of over 20 companies, including 4 not-for-profit
serving over 3 million Americans.Cambia blends data science with a compassionate human perspective to anticipate people’s needs, and empower them to make smarter health care choices..### *Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .* #J-18808-Ljbffr