Job Information
Cambia Health Solutions Clinical Pharmacist Consultant in Bellevue, Washington
Clinical Pharmacist Consultant Work from home within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Clinical Pharmacist Consultant's are living our mission to make health care easier and lives better. As a member of the Pharmacy Services team, our Clinical Pharmacist Consultant's you will provide expert clinical guidance and decision-making support, leveraging evidence-based medicine to optimize medication choices for efficacy, safety, and affordability. Key responsibilities include evaluating prior authorization requests, appeals, and retrospective claim reviews, providing coverage recommendations, and serving as a resource for medical directors, case managers, and other staff on clinical, policy, and benefit-related questions and interventions. You will also contribute to strategic planning and implementation of clinical initiatives, such as formulary management, medication therapy management programs, quality initiatives, and integrated pharmacy and case management strategies. Additionally, advanced responsibilities may include analy zing healthcare cost information, developing position papers, creating medication coverage policies, and collaborating on cross-functional projects that impact safety, quality, and affordability of pharmacy benefits. - all in service of creating a person-focused health care experience. What do you think are the most important factors in optimizing medication choices for efficacy, safety, and affordability? Are you a pharmacist looking to leverage your clinical expertise to drive high-quality, cost-effective pharmacy services? Then this may be the the perfect fit. What You Bring to Cambia: Qualifications: * Bachelor's degree in Pharmacy or Doctor of Pharmacy (PharmD) or Doctor of Pharmacy (PharmD) or related field * 3-5 years of experience in clinical acute care/hospital setting * Equivalent combination of education and experience * Pharmacy license. Successful completion of a pharmacy residency or advanced degree in health-related field preferred. Must be an active and unrestricted licensed pharmacist in state of practice. Skills and Attributes: * Clinical Expertise: Possess a strong clinical pharmacy background, with the ability to demonstrate clinical therapy skills and knowledge in a clinical care setting. * Communication and Analytical Skills: Excellent verbal and written communication skills, with strong business analytical skills and abilities. * Managed Care and Industry Knowledge: Proven success in managing professional relationships within managed care systems, medical groups, hospitals, or related organizations, with in-depth knowledge of pharmaceutical products and relevant laws and regulations. * Healthcare Economics and Financing: Strong understanding of healthcare economics and financing, including healthcare/pharmaceutical industry dynamics and pharmacy/provider service reimbursement of medications. * Regulatory Knowledge: Familiarity with state and federal laws and regulations governing the practice of pharmacy and healthcare industry practices, including DOLI, PPACA, HIPAA, and Medicare/CMS regulations. * Compliance and Operational Knowledge: Strong understanding of compliance-related activities, legislative and regulatory activities, health insurance operations, and legal issues, with knowledge of healthcare coding and payment systems. * Collaboration and Operational Skills: Ability to collaborate as part of cross-functional teams and work independently to prioritize work, meet deadlines, and achieve operational goals. What You To view the full job description,