Clinical Pharmacy Specialist, Pharmacy Benefits Manager (VIVO Health)

Job description

Job Description The Clinical Pharmacy Specialist is responsible for the development, implementation, and maintenance of drug formularies, clinical utilization management (UM) criteria, and evidence-based drug therapy guidelines, and overseeing pharmacy benefit claims adjudication to match formulary intent. This role involves critical evaluation of clinical literature, pharmacoeconomic data, and regulatory requirements to support P&T Committee decisions and ensure cost-effective, high-quality pharmaceutical care for plan members. Job Responsibility: - Develops and monitors the hospital’s policies/procedures regarding utilization of medications in collaboration with the medical staff, Pharmacy, and Therapeutics Committee; monitors medication utilization effectively and intervenes when necessary to ensure compliance. - Monitors pharmacists activities regarding utilization surveillance and provides instruction/education as necessary; maintains necessary and appropriate records regarding the effectiveness of these drug therapy regimens and provides information as required. - Ensures the safe and effective use of medication; guides staff in the provision of clinical services. - Provides...