Job Description
Role Description
The Clinical Utilization Management Pharmacist is responsible for delivering data-driven clinical and cost-containment strategies that optimize medication utilization, improve patient outcomes, and generate measurable value for long-term care pharmacy clients. This role leads therapeutic interchange initiatives, translates complex analytics into actionable insights, and partners cross-functionally with Clinical Services, Analytics, Operations, Account Management, and Sales to support the organization’s clinical value proposition and differentiation in the marketplace.
This position is a remote position. Applicants may live anywhere within the Continental USA with 10% travel.
- Schedule: Salaried, Monday through Friday.
- Lead the design, implementation, and ongoing management of therapeutic interchange and clinical utilization programs to optimize outcomes and contain costs.
- Ensure all clinical initiatives comply with applicable federal and state regulations, professional standards, corporate compliance requirements, and the Company’s Code of Business Conduct and Ethics.
- Support the development and rollout of new clinical programs in partnership with Clinical Services and Operations teams.
- Analyze clinical, utilization, and financial data to identify trends, patterns, and actionable opportunities for clinical improvement and cost containment.
- Translate analytical findings into clear, compelling insights for internal stakeholders and external clients.
- Collaborate with Client Reporting and Analytics teams to define analytical requirements and develop practical business solutions.
- Partner with Account Management and Sales teams to support client reviews, value demonstrations, and consultative discussions.
- Educate internal associates and external stakeholders on clinical programs, therapeutic interchange strategies, and utilization management initiatives.
- Provide clinical expertise in business reviews to demonstrate program effectiveness, outcomes, and return on investment.
- Monitor pharmacy, long-term care, and healthcare industry trends to proactively inform clinical strategy and cost containment recommendations.
- Qualifications
- PharmD degree
- Three (3) or more years of experience in clinical pharmacy, utilization management, or a related role
- Strong understanding of geriatric pharmacotherapy and long-term care clinical guidelines
- Demonstrated ability to design and execute targeted clinical and utilization programs
- Advanced analytical, organizational, and presentation skills
- Ability to communicate complex data clearly to both clinical and non-clinical audiences
- Proficiency in Microsoft Excel or pharmacy analytics tools
- Requirements
- Analytical thinking and problem-solving
- Strategic planning and execution
- Strong written and verbal communication skills
- Customer-focused and results-oriented mindset
- Ability to collaborate effectively across multidisciplinary teams
- Benefits
- Competitive pay
- Health, dental, vision and life insurance benefits
- Company paid STD and LTD
- Employee Discount Program
- 401k
- Paid-time off
- Tuition reimbursement
- Non-retail/Closed-door environment
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