Clinical Pharmacist - Navigation

Summary

Join Rightway PBM Clinical Operations team as a Clinical Pharmacist, Navigation, playing a key role in delivering a 'pharmacist in the family' approach to member engagement. Engage with members via phone, chat, and email, providing exceptional customer service and support. Perform core pharmacist duties, including drug utilization reviews and medication therapy management. Collaborate with the Navigation team and providers to address medication gaps and ensure formulary compliance. Contribute to pharmacy and therapeutics processes and support prior authorization reviews. Achieve productivity and quality metrics while contributing to the evolution of technology-enabled processes. Ensure regulatory standards are consistently met.

Requirements

• Pharmacy degree required, PharmD preferred
• 3 years in direct patient care such as PBM clinical operations or Health Plan Pharmacy Department or provision of Medication Therapy Management services
• Pharmacy License: Required: State of residence. Preferred: Multi-state licenses and/or be willing to attain licensure in additional states
• Core operating hours are weekdays within 8 am Eastern Time and 8 pm Pacific Time, but may be required to work an evening or weekend shift in the future as Rightway grows. On call approximately once every two months
• Empathetic, detail-oriented, intellectually and clinically curious, good listener, ability to challenge status quo, values exemplar
• Great clinician, effective & creative problem-solver, ability to prioritize and manage through change. Solid communication skills, ability to lead projects and influence others even without direct reporting line ownership
• Occasional travel may be required

Responsibilities

• Guide members as if you are the “Pharmacist in the Family” to help members manage their medications and disease states
• Engage with members via phone, chat, and email to provide a white glove/concierge experience for members
• Go above and beyond to answer member questions about all things pharmacy related
• Perform core Pharmacist duties including prospective/retrospective drug utilization reviews, comprehensive medication reviews, and recommending changes to patient's drug regimens
• Partners with Rightway’s Navigation team where needed to provide holistic support to members
• Engages with providers to address medication gaps in therapy for patients, drug therapy recommendations, formulary compliance, and serve as a subject matter expert on medications
• Contributes to the Pharmacy & Therapeutics process in the research, preparation and presentation of drug monographs, therapeutic category reviews and clinical policy development.  Ensures that these processes meet or exceed regulatory and best practice standards
• Supports prior authorization review process as needed regarding drug product selection and formulary compliance to ensure quality of care
• Effectively collaborate with third-parties in the administration of Rightway’s clinical pharmacy strategy
• Responsible for achieving productivity and quality of work metrics for clinical pharmacy interactions
• Contribute to the design and evolution of technology-enabled processes to create a scalable clinical pharmacy operation
• Ensures regulatory standards are consistently met

Preferred Qualifications

Managed Care or other pharmacy residency preferred

Benefits

BASE SALARY: $120-$128K