Medica
Overview
Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We are a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration. The mission is to be there in the moments that matter most for our members and employees, creating a community of connected care where coordinated, quality service is the norm and every member feels valued.
Position The Clinical Pharmacist, Medical Pharmacy is a member of the clinical pharmacy team. The incumbent has responsibility and accountability for overseeing the medical pharmacy clinical strategy for all business segments including IFB, Commercial, Medicaid and Medicare. Key accountabilities include leading medical pharmacy policy development and utilization management for all segments, new medical drug clinical assessment and management strategy, and oversight for both internal and delegated medical pharmacy management services. This role navigates cross-functional processes and systems within and outside the organization and presents medical pharmacy trends and opportunities to key strategic clients. It works closely with the Manager, Clinical Pharmacy to ensure alignment between strategic, clinical, and operational strategies within Pharmacy Services to deliver efficient, effective, and high-quality medical pharmacy services to customers. Performs other duties as assigned.
Key Accountabilities
Provides oversight and support for all aspects of the medical pharmacy benefit, including drug policies, clinical services, and utilization management.
Develops and implements strategies to manage medical drug costs and improve member outcomes across all segments and markets.
Prepares and presents medical drug reviews at Medica's formal approval committee.
Reviews and analyzes medical drug utilization data to ensure optimal usage of medications.
Ensures access to cost-effective medical drugs for customers.
Develops and implements medical pharmacy policies and procedures.
Ensures compliance with regulatory standards across all segments and markets.
Ensures the efficient and effective delivery of medical pharmacy services for customers.
Represents medical pharmacy services and actively participates in internal and external cross-functional meetings.
Maintains up-to-date knowledge of new drugs, therapeutic trends, and healthcare laws and regulations.
Maintains accurate and current records of all medical pharmacy decisions and changes.
Addresses inquiries and disputes related to medical pharmacy authorization decisions.
Completes projects as assigned and actively participates in internal and external pharmacy meetings.
Required Qualifications
Bachelor's Degree, B.S. Pharmacy or PharmD required
7 years of work experience beyond degree
Required Certifications/Licensure
Active Pharmacist License
Preferred Qualifications
1+ year related work experience specifically focused on medical pharmacy management
Prior experience with medical pharmacy policy development and utilization management preferred
Organized and can simultaneously execute through multiple projects and priorities
Proven track record on consistently achieving desired results
Self-starter, with willingness and ambition to work through ambiguity
Creative thinker
Excellent analytical and decision-making skills
Motivated to problem solve
Ability to present to an executive audience
Collaborative, team-oriented spirit
Excellent written and verbal communication skills
Customer/patient focused
This position is an office role, requiring onsite work on average 3 days per week. Candidate locations include Minnetonka, MN; Madison, WI; Omaha, NE; or St. Louis, MO.
The full salary grade for this position is $111,200 - $190,600. The typical hiring salary range is expected to be $111,200 - $166,740, with placement depending on education, experience, certifications, scope, internal pay equity, and external market data. In addition to base compensation, eligibility for incentive plan compensation may apply. Medica offers a generous total rewards package including medical, dental, vision, PTO, holidays, paid volunteer time off, 401K contributions, caregiver services, and other benefits.
The compensation and benefits information is provided as of the posting date and is subject to change. Medica’s compensation and benefits are subject to change at any time, with or without notice, in accordance with applicable law.
We are an Equal Opportunity employer. All qualified candidates will receive consideration for employment regardless of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For information, please review the Know Your Rights notice from the Department of Labor.
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Position The Clinical Pharmacist, Medical Pharmacy is a member of the clinical pharmacy team. The incumbent has responsibility and accountability for overseeing the medical pharmacy clinical strategy for all business segments including IFB, Commercial, Medicaid and Medicare. Key accountabilities include leading medical pharmacy policy development and utilization management for all segments, new medical drug clinical assessment and management strategy, and oversight for both internal and delegated medical pharmacy management services. This role navigates cross-functional processes and systems within and outside the organization and presents medical pharmacy trends and opportunities to key strategic clients. It works closely with the Manager, Clinical Pharmacy to ensure alignment between strategic, clinical, and operational strategies within Pharmacy Services to deliver efficient, effective, and high-quality medical pharmacy services to customers. Performs other duties as assigned.
Key Accountabilities
Provides oversight and support for all aspects of the medical pharmacy benefit, including drug policies, clinical services, and utilization management.
Develops and implements strategies to manage medical drug costs and improve member outcomes across all segments and markets.
Prepares and presents medical drug reviews at Medica's formal approval committee.
Reviews and analyzes medical drug utilization data to ensure optimal usage of medications.
Ensures access to cost-effective medical drugs for customers.
Develops and implements medical pharmacy policies and procedures.
Ensures compliance with regulatory standards across all segments and markets.
Ensures the efficient and effective delivery of medical pharmacy services for customers.
Represents medical pharmacy services and actively participates in internal and external cross-functional meetings.
Maintains up-to-date knowledge of new drugs, therapeutic trends, and healthcare laws and regulations.
Maintains accurate and current records of all medical pharmacy decisions and changes.
Addresses inquiries and disputes related to medical pharmacy authorization decisions.
Completes projects as assigned and actively participates in internal and external pharmacy meetings.
Required Qualifications
Bachelor's Degree, B.S. Pharmacy or PharmD required
7 years of work experience beyond degree
Required Certifications/Licensure
Active Pharmacist License
Preferred Qualifications
1+ year related work experience specifically focused on medical pharmacy management
Prior experience with medical pharmacy policy development and utilization management preferred
Organized and can simultaneously execute through multiple projects and priorities
Proven track record on consistently achieving desired results
Self-starter, with willingness and ambition to work through ambiguity
Creative thinker
Excellent analytical and decision-making skills
Motivated to problem solve
Ability to present to an executive audience
Collaborative, team-oriented spirit
Excellent written and verbal communication skills
Customer/patient focused
This position is an office role, requiring onsite work on average 3 days per week. Candidate locations include Minnetonka, MN; Madison, WI; Omaha, NE; or St. Louis, MO.
The full salary grade for this position is $111,200 - $190,600. The typical hiring salary range is expected to be $111,200 - $166,740, with placement depending on education, experience, certifications, scope, internal pay equity, and external market data. In addition to base compensation, eligibility for incentive plan compensation may apply. Medica offers a generous total rewards package including medical, dental, vision, PTO, holidays, paid volunteer time off, 401K contributions, caregiver services, and other benefits.
The compensation and benefits information is provided as of the posting date and is subject to change. Medica’s compensation and benefits are subject to change at any time, with or without notice, in accordance with applicable law.
We are an Equal Opportunity employer. All qualified candidates will receive consideration for employment regardless of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr