Medica
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Clinical Pharmacist
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Medica 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 — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Overview
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 policy development and utilization management for all segments, medical drug clinical assessment and management strategy, and oversight for internal and delegated medical pharmacy management services. This role works cross-functionally within and outside the organization and presents medical pharmacy trends and opportunities to key strategic clients. The position collaborates with the Manager, Clinical Pharmacy to align strategic, clinical, and operational objectives within Pharmacy Services to deliver high-quality medical pharmacy services. Responsibilities
Provide oversight and support for all aspects of the medical pharmacy benefit, including drug policies, clinical services, and utilization management. Develop and implement strategies to manage medical drug costs and improve member outcomes across all segments and markets. Prepare and present medical drug reviews at Medica’s formal approval committee. Review and analyze medical drug utilization data to ensure optimal medication use. Ensure access to cost-effective medical drugs for customers. Develop and implement medical pharmacy policies and procedures. Ensure compliance with regulatory standards across all segments and markets. Ensure efficient and effective delivery of medical pharmacy services for customers. Represent medical pharmacy services and participate in internal and external cross-functional meetings. Maintain up-to-date knowledge of new drugs, therapeutic trends, and healthcare laws and regulations. Maintain accurate and current records of medical pharmacy decisions and changes. Address inquiries and disputes related to medical pharmacy authorization decisions. Complete projects as assigned and participate 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 of related work experience focused on medical pharmacy management Prior experience with medical pharmacy policy development and utilization management Organized and capable of executing multiple projects and priorities Proven track record of achieving results Self-starter with ability to work through ambiguity Creative thinker with excellent analytical and decision-making skills Motivated to problem solve and present to an executive audience Collaborative, team-oriented mindset with strong written and verbal communication Customer/patient focused Job Details
This position is an on-site Office role, typically requiring 3 days per week in the office. Accepting candidates near one of the following locations: Minnetonka, MN; Madison, WI; Omaha, NE; or St. Louis, MO. Compensation and Benefits
The full salary grade for this position is $111,200 - $190,600. The typical hiring salary range is $111,200 - $166,740. Annual salary may vary based on education, experience, certifications/licensure, scope of role, pay equity, and market data. Eligible for incentive plan compensation in addition to base salary. Medica offers a comprehensive total rewards package including medical, dental, vision, PTO, holidays, paid volunteer time off, 401(k) contributions, and other benefits. Equal Opportunity
Medica is an Equal Opportunity employer. All qualified candidates receive consideration for employment without regard to race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
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Clinical Pharmacist
role at
Medica 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 — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Overview
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 policy development and utilization management for all segments, medical drug clinical assessment and management strategy, and oversight for internal and delegated medical pharmacy management services. This role works cross-functionally within and outside the organization and presents medical pharmacy trends and opportunities to key strategic clients. The position collaborates with the Manager, Clinical Pharmacy to align strategic, clinical, and operational objectives within Pharmacy Services to deliver high-quality medical pharmacy services. Responsibilities
Provide oversight and support for all aspects of the medical pharmacy benefit, including drug policies, clinical services, and utilization management. Develop and implement strategies to manage medical drug costs and improve member outcomes across all segments and markets. Prepare and present medical drug reviews at Medica’s formal approval committee. Review and analyze medical drug utilization data to ensure optimal medication use. Ensure access to cost-effective medical drugs for customers. Develop and implement medical pharmacy policies and procedures. Ensure compliance with regulatory standards across all segments and markets. Ensure efficient and effective delivery of medical pharmacy services for customers. Represent medical pharmacy services and participate in internal and external cross-functional meetings. Maintain up-to-date knowledge of new drugs, therapeutic trends, and healthcare laws and regulations. Maintain accurate and current records of medical pharmacy decisions and changes. Address inquiries and disputes related to medical pharmacy authorization decisions. Complete projects as assigned and participate 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 of related work experience focused on medical pharmacy management Prior experience with medical pharmacy policy development and utilization management Organized and capable of executing multiple projects and priorities Proven track record of achieving results Self-starter with ability to work through ambiguity Creative thinker with excellent analytical and decision-making skills Motivated to problem solve and present to an executive audience Collaborative, team-oriented mindset with strong written and verbal communication Customer/patient focused Job Details
This position is an on-site Office role, typically requiring 3 days per week in the office. Accepting candidates near one of the following locations: Minnetonka, MN; Madison, WI; Omaha, NE; or St. Louis, MO. Compensation and Benefits
The full salary grade for this position is $111,200 - $190,600. The typical hiring salary range is $111,200 - $166,740. Annual salary may vary based on education, experience, certifications/licensure, scope of role, pay equity, and market data. Eligible for incentive plan compensation in addition to base salary. Medica offers a comprehensive total rewards package including medical, dental, vision, PTO, holidays, paid volunteer time off, 401(k) contributions, and other benefits. Equal Opportunity
Medica is an Equal Opportunity employer. All qualified candidates receive consideration for employment without regard to race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
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