“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”
This position is not eligible for Sponsorship.
MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!
Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!
Summary
The Drug Classification & Maintenance Pharmacist participates in the development and maintenance of Core Formulary Processes focusing on the Formulary Maintenance Weekly Drug Update activities including Proxy and CUI maintenance related to the Part D MedImpact Standard and Custom formularies and other functions as required
Essential Duties and Responsibilities include the following. Other duties may be assigned.
• Principal SME Pharmacist on CMS Part D drug eligibility and placement. Maintains and oversees appropriate Part D assignment and CUI mappings of drugs consistent within utilization management groupings of drugs. Reviews new drug categorization changes to customize, implement, and integrate with MedImpact formulary products as appropriate. Monitors drug vendor and regulatory bodies for operational or strategic market changes. Collaborates with the MedImpact National Drug Data File (NDDF) Team as well as MedImpact Drug Information Services to ensure success.
• Performs complex data analytics based upon external drug data provided to MedImpact by FDB, MediSpan, RXNorm and CMS FRF.
• Acts as a clinical and analytical subject matter expert on areas pertaining to Part D drug mapping and classification and supports development and implementation of mapping and PPDL programs.
• Responsible for interpretation and implementation of CMS guidance related to each of the Part D PPDL drug lists. Maintains Formulary Services’ CMS Part D Pre-Processing Drug Lists (PPDL) which include weekly review and yearly update CMS_PPDL Drug Lists: The accurate maintenance of lists is essential to CMS Part D compliance and accurate claim adjudication.
• Processes the monthly / yearly CMS FRF and NIH’s RxNorm drug update files to ensure accurate and compliant file submission to CMS.
• Serves as Drug Data Management’s designated contact for communication to NIH’s RxNorm for general inquiries and data correction requests.
• Masters a variety of analytical and quality control tools to ensure formulary drug data accuracy and integrity. Simultaneously engages in the activities and timelines for multiple CMS Plan years with differing and sometimes conflicting rules and regulations.
• Contributes to and assists with current Drug Data Management and formulary enterprise priority projects, programs, or initiatives as defined by leadership. Coordinates inter- and intradepartmental project activities and groups as necessary to meet project goals and timeframes.
• Provides internal consultation on CMS statutory regulations specific to Part D eligibility status and Part D related GPS programs PPDL drug lists.
• Executes within the confines and timeframes provided by CMS which may include non-standard business hours.
• Collaborate with MedImpact’s Health Services advisors, Formulary Administration Pharmacists, IT partners, NDDF (FDB / MediSpan), Drug Information, Configuration Services team to ensure accurate drug mapping and classifications contents abide by Part D guidance.
• Ensures that the mapping and classification changes occur in an appropriate, accurate, and timely manner based on drug data and Part D guidance.
Supervisory Responsibilities
No supervisory responsibilities
Client Responsibilities
This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
PharmD and 3+ years’ experience or equivalent combination of education and experience, and 1 year of SME in respective areas
Computer Skills
To perform this job successfully, an individual must have solid computer skills including Microsoft Office (Word/Excel), MS Outlook and familiarity with industry standard databases. Understand, create and execute basic SQL queries and relational databases
Certificates, Licenses, Registrations
Valid Registered Pharmacist license in the State of California or equivalent state
Other Skills and Abilities
Reasoning Ability
Mathematical Skills
Language Skills
Competencies To perform the job successfully, an individual should demonstrate the following competencies:
Composure
Decision Quality
Organizational Agility
Problem Solving
Customer Focus
Drive for Results
Peer Relations
Time Management
Dealing with Ambiguity
Learning on the Fly
Political Savvy
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).
Work Location
This position must work on-site at the San Diego Headquarters for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Remote work is not an option for these purposes.
Working Hours
This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, at weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.
Travel
This position requires no travel; however attendance may be required at various local conferences and meetings.
To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers
MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.