Cambia Health Solutions
Clinical Pharmacist Consultant
Cambia Health Solutions, Washington, District of Columbia, us, 20022
Overview
Clinical Pharmacist Consultant or Sr. DOE — Work from home within Oregon, Washington, Idaho or Utah. Candidates must be available to work Pacific Standard Time (PST) hours irrespective of their physical location. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Cambia Health Solutions is seeking a Clinical Pharmacist Consultant to provide professional and clinical pharmacy expertise, apply evidence-based medicine evaluations, and support formulary management and drug utilization strategies. What You Will Do At Cambia
Provide clinical decision-making based on best practices in applying evidence-based medicine to determine medications with best value for efficacy and safety. Provide coverage recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable policies and member contracts. Complete peer-to-peer conversations with external healthcare professionals. Develop position papers, medication coverage policies, formulary monographs and class reviews, and formulary recommendations based on critical appraisal of scientific literature and input from practicing physicians. Present and communicate clinical positions on medication analysis in a clear and concise manner. Responsibilities and Qualifications
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 an equivalent combination of education and experience. Active and unrestricted pharmacy license; successful completion of a pharmacy residency or advanced degree in health-related field preferred. Strong clinical pharmacy background with ability to demonstrate clinical therapy skills in a clinical care setting. Excellent verbal and written communication skills; strong analytical, project management, and coordination abilities. Ability to work independently, prioritize work, meet deadlines, and achieve operational goals. Experience managing professional relationships in managed care, medical groups, hospitals, or related organizations; ability to collaborate on cross-functional teams. Knowledge of pharmaceutical products, regulatory requirements, health care economics, payer design, and reimbursement systems. What You Will Need to Succeed
Knowledge of health plan and benefit design structures; Medicare/CMS regulations; health care coding and payment systems (ICD-9, CPT, HCPCS, NDC). Strong understanding of compliance, regulatory activities, health insurance operations, and related legal issues. Compensation
The expected hiring range for a Clinical Pharmacist Consultant is $120,700 - $163,300 depending on skills, experience, education, licensure/certifications, and performance history. Bonus target: 15%. Current full salary range: $113,000 - $185,000. The expected hiring range for a Clinical Pharmacist Consultant Sr. is $134,300 - $181,700 with a 20% bonus target. Current full salary range: $126,000 - $206,000. About Cambia
Working at Cambia means being part of a purpose-driven culture built on trust and innovation with a 100+ year history. We value compassion, teamwork, and a patient-centered approach to health care. Benefits
Medical, dental, and vision coverage for employees and eligible family members (including mental health benefits). Health savings account with annual employer contribution. Generous paid time off and holidays. Market-leading retirement plan with company match; potential discretionary contribution. Parental leave and wellbeing programs. Employee Assistance Fund and other wellness resources We offer work-from-home options for most roles. A wired internet connection with minimum speeds is required. We are an Equal Opportunity employer with a drug- and tobacco-free workplace. Background check required. For accommodations during the application process, email CambiaCareers@cambiahealth.com. See our Privacy Policy for details.
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Clinical Pharmacist Consultant or Sr. DOE — Work from home within Oregon, Washington, Idaho or Utah. Candidates must be available to work Pacific Standard Time (PST) hours irrespective of their physical location. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Cambia Health Solutions is seeking a Clinical Pharmacist Consultant to provide professional and clinical pharmacy expertise, apply evidence-based medicine evaluations, and support formulary management and drug utilization strategies. What You Will Do At Cambia
Provide clinical decision-making based on best practices in applying evidence-based medicine to determine medications with best value for efficacy and safety. Provide coverage recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable policies and member contracts. Complete peer-to-peer conversations with external healthcare professionals. Develop position papers, medication coverage policies, formulary monographs and class reviews, and formulary recommendations based on critical appraisal of scientific literature and input from practicing physicians. Present and communicate clinical positions on medication analysis in a clear and concise manner. Responsibilities and Qualifications
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 an equivalent combination of education and experience. Active and unrestricted pharmacy license; successful completion of a pharmacy residency or advanced degree in health-related field preferred. Strong clinical pharmacy background with ability to demonstrate clinical therapy skills in a clinical care setting. Excellent verbal and written communication skills; strong analytical, project management, and coordination abilities. Ability to work independently, prioritize work, meet deadlines, and achieve operational goals. Experience managing professional relationships in managed care, medical groups, hospitals, or related organizations; ability to collaborate on cross-functional teams. Knowledge of pharmaceutical products, regulatory requirements, health care economics, payer design, and reimbursement systems. What You Will Need to Succeed
Knowledge of health plan and benefit design structures; Medicare/CMS regulations; health care coding and payment systems (ICD-9, CPT, HCPCS, NDC). Strong understanding of compliance, regulatory activities, health insurance operations, and related legal issues. Compensation
The expected hiring range for a Clinical Pharmacist Consultant is $120,700 - $163,300 depending on skills, experience, education, licensure/certifications, and performance history. Bonus target: 15%. Current full salary range: $113,000 - $185,000. The expected hiring range for a Clinical Pharmacist Consultant Sr. is $134,300 - $181,700 with a 20% bonus target. Current full salary range: $126,000 - $206,000. About Cambia
Working at Cambia means being part of a purpose-driven culture built on trust and innovation with a 100+ year history. We value compassion, teamwork, and a patient-centered approach to health care. Benefits
Medical, dental, and vision coverage for employees and eligible family members (including mental health benefits). Health savings account with annual employer contribution. Generous paid time off and holidays. Market-leading retirement plan with company match; potential discretionary contribution. Parental leave and wellbeing programs. Employee Assistance Fund and other wellness resources We offer work-from-home options for most roles. A wired internet connection with minimum speeds is required. We are an Equal Opportunity employer with a drug- and tobacco-free workplace. Background check required. For accommodations during the application process, email CambiaCareers@cambiahealth.com. See our Privacy Policy for details.
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