Aetna Clinical Pharmacist Licensed Telework East Coast in Albany, New York
Req ID: 50645BR
Work at home position on eastern time!
As a key member of the Formulary development team, the primary role of the Clinical Pharmacist will be to support the successful development, implementation, and maintenance of Aetnas Medicare Part D formularies and utilization management initiatives. This individual will oversee proper administration of Med D formularies consistent with CMS regulations and Aetna Medicare policies. This team member will utilize sound understanding of Clinical guidelines, managed care principals, trend information, pricing, and cost modeling practices for formulary initiatives.
Fundamental Components but not limited to the following:
Assess trends and clinical guidelines for the creation and maintenance of a portfolio of formularies to support PDP, MAPD and employer group Medicare sales
Propose tiering, UM and criteria for new drugs and generics. Prepare drug reviews involving clinical information, utilization, financial considerations, and market analysis for discussion during weekly and annual strategy meetings.
Work with stakeholders to identify business needs, compliance needs and market needs in developing portfolio of Part D formularies.
Sheppard new drugs thru strategy, P&T and CMS submission of drug
Develop appropriate UM strategies to meet goals of safe and cost effective use of Part D drugs
Serve as SME for formulary intent thru the formulary implementation process as a liaison to our implementation and operational teams in collaboration with the PBM vendor.
Support Aetna partners in creation of AEP marketing materials, ancillary sales materials, & formulary education materials around formulary offerings.
Participate in P&T and quarterly trend meetings
Support clinical aspects of formulary thru HPMS submission, monthly FRF process etc.
Monitor and identify new brand and generic drugs to market through the review of the Medispan file.
Manage policy and procedures related to maintenance of Medicare formularies.
Desired Skills: Firm understanding of the Medicare bid cycle, formulary development, bid experience, experience managing or overseeing PBM relationship, vendor management, strong foundation in Medicare guidance, excel skills, project management skills and ability to work successfully in a matrix environment.
Registered Pharmacist in state resides in required
Board certification and residency preferred
Previous (3 years) clinical pharmacy experience required.
Managed care experience preferred.
Understanding of medical and pharmacy terminology.
Knowledge of clinical program components, formulary designs, and prescription benefit trends.
Project Management/ is desired
Medical Management/ is desired
The minimum level of education desired for candidates in this position is a Doctor of Pharmacy OR
Bachelor's degree from an accredited school of pharmacy or Pharm.D from an accredited school of pharmacy required.
LICENSES AND CERTIFICATIONS
Pharmacy/Licensed Pharmacist is required
Functional - Products-Medical/Medicare Advantage Prescription Drug Plan/1-3 Years
Functional - Clinical / Medical//
Functional - Communications//
Technical - Desktop Tools/TE Microsoft Excel/4-6 Years/
Technical - Remote Access/WAH (Work at Home)/1-3 Years/
Technical - Desktop Tools/Microsoft SharePoint/4-6 Years/
Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/
Full-Time Telework (WAH)
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Health Care