Moda Health
About Moda
Moda
Health was founded in Oregon in 1955. Moda is focused on building a better future for healthcare by offering coverage to members, support to the community, and comprehensive benefits to employees. Moda values diversity and inclusion and invites applications from candidates who share this commitment. Our diverse experiences help us become a stronger organization. Let’s do great things, together! Position Summary
We are seeking a clinical pharmacist with a focus on industry relations. The domain experience requires both foundational clinical pharmacy expertise and an interest in partnering with pharmaceutical and biotechnology companies and other vendor partners engaged in contracting opportunities such as rebate management and clinical programs. This position supports formulary and policy development, drives to the lowest net cost as guided by clinical strategies, and communicates this value to key stakeholders. The role includes reviewing rebate initiatives for medications covered under pharmacy and medical benefits across commercial, Exchange, Medicare, and Managed Medicaid. The role also facilitates or supports project implementations with external and internal stakeholders.
This is a FT hybrid position based in Portland, Oregon. Responsibilities
Obtain and review rebate offerings for existing therapeutic strategies to support formulary performance and identify opportunities from contracting changes or new market entrants that are FDA-approved. Collaborate with vendor partners (PBM, medical management companies, and others) on policy or formulary changes driven by cost analysis, including rebate considerations or contracting. Request and identify medical and pharmacy rebates across all lines of business (commercial, Exchange, Managed Medicaid, custom clients, and Medicare as needed). Support and/or lead client-facing presentations within industry relations as necessary. Coordinate with legal and regulatory teams to understand the impact on formulary strategies and financial implications for potential compliance-driven updates due to changes in business states. Monitor changes and prepare for pipeline and market events. Develop concise, applicable, comprehensive, and timely communiques for members, providers, internal, or external stakeholders. Provide clinical support services intersecting industry relations or business development (benefit design, formulary analysis, drug information, P&T participation, client support, and drug utilization management). Provide clinical expertise focusing on industry relations to key stakeholders in Pharmacy and Benefits, including indication-based dosing and therapeutic landscape definition. Contribute to, update, and maintain policies and procedures related to industry relations. Lead, when needed, weekly drug compendia formulary management files from both clinical pharmacy and industry relations perspectives. Complete significant projects and perform other related duties as assigned. Adhere to HR policies, Code of Conduct, and department procedures including protecting confidential information. Qualifications
Doctor of Pharmacy degree (Pharm.D.) preferred. Current active and unrestricted Oregon Pharmacist license, or eligibility for Oregon licensure within 60 days of hire. Two to three years of managed care experience or training from an accredited managed care residency program. Strong analytical skills and business acumen. Ability to communicate and present technical information to diverse audiences. Ability to work independently and collaborate cross-functionally with various stakeholders. Project management skills and the ability to plan and execute projects. Commitment to service, values, and professionalism. Ability to maintain confidentiality and project a professional business image. Ability to work under pressure with interruptions and shifting priorities. Strong written and verbal communication skills. Proficiency with Microsoft Word, Excel, Outlook, and PowerPoint. Benefits
Medical, Dental, Vision, Pharmacy, Life, & Disability 401K Matching FSA Employee Assistance Program PTO and Company Paid Holidays Working Conditions
Remote, office, and/or hybrid environment with extensive computer use. May require extended hours including evenings and occasional weekends. Some travel to conferences or offsite meetings. Internal collaboration with Clinical Pharmacy, Marketing, Sales & Account Services, Actuary & Underwriting, Healthcare Services, Customer Service, Information Technology, Benefits, Regulatory Affairs, Legal, and Membership Accounting. External collaboration with PBM, medical management vendors, pharmaceutical/biotechnology manufacturers, benefit managers, clients, providers, and pharmacists. EEO notice : Moda Health seeks to provide equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. For accommodations, please contact Kristy Nehler and Danielle Baker at humanresources@modahealth.com. Seniorirty level
Entry level Employment type
Full-time Job function
Health Care Provider Industries Insurance
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Moda
Health was founded in Oregon in 1955. Moda is focused on building a better future for healthcare by offering coverage to members, support to the community, and comprehensive benefits to employees. Moda values diversity and inclusion and invites applications from candidates who share this commitment. Our diverse experiences help us become a stronger organization. Let’s do great things, together! Position Summary
We are seeking a clinical pharmacist with a focus on industry relations. The domain experience requires both foundational clinical pharmacy expertise and an interest in partnering with pharmaceutical and biotechnology companies and other vendor partners engaged in contracting opportunities such as rebate management and clinical programs. This position supports formulary and policy development, drives to the lowest net cost as guided by clinical strategies, and communicates this value to key stakeholders. The role includes reviewing rebate initiatives for medications covered under pharmacy and medical benefits across commercial, Exchange, Medicare, and Managed Medicaid. The role also facilitates or supports project implementations with external and internal stakeholders.
This is a FT hybrid position based in Portland, Oregon. Responsibilities
Obtain and review rebate offerings for existing therapeutic strategies to support formulary performance and identify opportunities from contracting changes or new market entrants that are FDA-approved. Collaborate with vendor partners (PBM, medical management companies, and others) on policy or formulary changes driven by cost analysis, including rebate considerations or contracting. Request and identify medical and pharmacy rebates across all lines of business (commercial, Exchange, Managed Medicaid, custom clients, and Medicare as needed). Support and/or lead client-facing presentations within industry relations as necessary. Coordinate with legal and regulatory teams to understand the impact on formulary strategies and financial implications for potential compliance-driven updates due to changes in business states. Monitor changes and prepare for pipeline and market events. Develop concise, applicable, comprehensive, and timely communiques for members, providers, internal, or external stakeholders. Provide clinical support services intersecting industry relations or business development (benefit design, formulary analysis, drug information, P&T participation, client support, and drug utilization management). Provide clinical expertise focusing on industry relations to key stakeholders in Pharmacy and Benefits, including indication-based dosing and therapeutic landscape definition. Contribute to, update, and maintain policies and procedures related to industry relations. Lead, when needed, weekly drug compendia formulary management files from both clinical pharmacy and industry relations perspectives. Complete significant projects and perform other related duties as assigned. Adhere to HR policies, Code of Conduct, and department procedures including protecting confidential information. Qualifications
Doctor of Pharmacy degree (Pharm.D.) preferred. Current active and unrestricted Oregon Pharmacist license, or eligibility for Oregon licensure within 60 days of hire. Two to three years of managed care experience or training from an accredited managed care residency program. Strong analytical skills and business acumen. Ability to communicate and present technical information to diverse audiences. Ability to work independently and collaborate cross-functionally with various stakeholders. Project management skills and the ability to plan and execute projects. Commitment to service, values, and professionalism. Ability to maintain confidentiality and project a professional business image. Ability to work under pressure with interruptions and shifting priorities. Strong written and verbal communication skills. Proficiency with Microsoft Word, Excel, Outlook, and PowerPoint. Benefits
Medical, Dental, Vision, Pharmacy, Life, & Disability 401K Matching FSA Employee Assistance Program PTO and Company Paid Holidays Working Conditions
Remote, office, and/or hybrid environment with extensive computer use. May require extended hours including evenings and occasional weekends. Some travel to conferences or offsite meetings. Internal collaboration with Clinical Pharmacy, Marketing, Sales & Account Services, Actuary & Underwriting, Healthcare Services, Customer Service, Information Technology, Benefits, Regulatory Affairs, Legal, and Membership Accounting. External collaboration with PBM, medical management vendors, pharmaceutical/biotechnology manufacturers, benefit managers, clients, providers, and pharmacists. EEO notice : Moda Health seeks to provide equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. For accommodations, please contact Kristy Nehler and Danielle Baker at humanresources@modahealth.com. Seniorirty level
Entry level Employment type
Full-time Job function
Health Care Provider Industries Insurance
#J-18808-Ljbffr