Department OverviewThe PBM Pharmacist provides clinical support to OHSU Pharmacy Benefit Management Services. Support
includes but is not limited to formulary management, coverage determinations, Pharmacy and Therapeutics Committee support, responding to clinical inquiries, and implementing clinical programs.
Function/Duties of Position- Formulary management including but not limited to activities such as adjudication, formulary decision making, and benefit determination.
- Respond to and resolve clinical inquiries from members, clients, providers, or pharmacies related to formulary options, therapeutic alternatives, and coverage determinations.
- Complete prior authorization requests for members through collaboration with PBM Pharmacy Technicians.
- Coordinate with pharmacy claims processor to ensure formularies, clinical edits, and plan designs are implemented according to requirements.
- Assist with developing and presenting drug monographs, executive summaries, therapeutic class reviews, and medication policies to Pharmacy & Therapeutics Committees.
- Utilize claims data to evaluate benefit design for inappropriate utilization and opportunities to improve outcomes and optimize drug spend.
Required Qualifications- A current Pharmacist's license issued by the Oregon State Board of Pharmacy.
- OHSU may require training or experience in a specialized area at time of recruitment.
Job Related Knowledge, Skills and Abilities (Competencies):- Drug therapy knowledge (Dosage, indications, side effects, etc.)
- Contemporary medication use systems
- Drug information through written and verbal consults as well as monographs
- Interpersonal communication
- Excellent organizational skills
- Supervisory concepts (for indirect reports)
- Problem solving
Preferred Qualifications- B.S. Pharmacy or Pharm.D.
- Pharmacy practice residency or three years equivalent work experience
- 2 years or more in managed care, health plan or pharmacy benefit management setting
- PBM operational experience
- Specialty pharmacy practice
- Pharmacy benefit design
- Pharmacy & Therapeutics Committee participation
- Medication policy development
- Pipeline development
- Project management skills
Additional DetailsThe PBM pharmacist will experience competing demands and frequent interruptions from PBM Technicians, clients, members, and other health care professionals.
Benefits:- Healthcare Options - Covered 100% for full-time employees and 88% for dependents, and $25K of term life insurance provided at no cost to the employee
- Two separate above market pension plans to choose from
- Vacation- up to 200 hours per year depending on length of service
- Sick Leave- up to 96 hours per year
- 8 paid holidays per year
- Substantial Tri-met and C-Tran discounts
- Additional Programs including: Tuition Reimbursement and Employee Assistance Program (EAP)
