Clinical Pharmacist - Specialty Drug Program

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!

Learn more about our unique benefit offerings here.

Want to know more? You can learn about life at Wellmark here.

The health care industry is changing, and Wellmark is working to help transform it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. We’ve embarked on a journey to support our members use and navigate the health care system in order to help them make clear, informed decisions, and we’re also ensuring that we take a team-centric approach when working with and in support of our members. The work that our diverse business and care teams are doing in collaboration with our health care partners will create these changes, all while working to minimize health care costs.

Use your strengths as a Clinical Pharmacist – Specialty Drug Program and join our growing Pharmacy Services team!

In order for our members to have the best pharmaceutical solutions, we need to first ensure our clinical strategy is supported and managed to strengthen Specialty Drug programs that impact cost of care. That’s where you come in! In this role, you’ll develop core clinical programs to help manage Specialty Drug spend. Timely monitoring of program effectiveness through transparent reporting of measurable outcomes will be key. By leveraging your industry knowledge of best practices, you will develop, innovate and record approaches to achieve program goals. But you won’t do it alone! In collaboration with the Health and Pharmacy Services team, other Wellmark stakeholders, and Wellmark’s P&T committee, you will be responsible for the development and maintenance of evidence-based policies and clinical programs to improve quality and affordability outcomes for our members.

The ideal candidate will have a strong clinical background and be able to consume and interpret new pharmaceutical literature and evidence to effectively communicate, verbally and in writing, the research with the P&T committee, provider network and internal Wellmark stakeholders. The ideal candidate will have the knowledge to review evidence-based research, interpret and present data to inform decisions, and contribute to the overall growth and operations of the specialty pharmacy program. They possess strong organization and prioritization skills and thrive in a fast-paced environment where things are changing and evolving.

This position will work a hybrid schedule of at least 3 days in Wellmark's Des Moines office (Tuesday-Thursday), with Monday & Friday remote option.

Required:

• Bachelor's degree in Pharmacy OR PharmD.
• An active and unrestricted Pharmacy license in Iowa or South Dakota (individual must be licensed in the state in which they reside) is required within 6 months from date of hire.
• 5+ years of managed care pharmacy (PBM or Health Plan), OR 3+ years of specialty pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
• Excellent analytical, problem solving, and critical thinking skills. Ability to make effective evidence-based decisions.
• Advanced knowledge of medical literature retrieval and evaluation.
• Excellent written and verbal communication skills. Ability to effectively articulate complex information across all levels of an organization. Strong presentation skills.
• Strong consulting and interpersonal skills to quickly build rapport, credibility, and collaborative partnerships with clinical peers, leaders, and stakeholders.
• Proficient in Microsoft Office & intermediate Excel skills – e.g., pivot tables, trend analysis, formulas.
• Continually expand pharmacy industry knowledge and ability to understand the clinical landscape, including impacts to programs/ services.
• Strong organization and prioritization skills. Ability to manage multiple projects simultaneously and consistently meet deadlines.

Preferred:

• Board Certification in Oncology (BCOP) from the Board of Pharmacy Specialties.
• Specialty pharmacy cost of care strategy experience preferred.
• Oncology clinical program implementation experience preferred.
• Experience with pharmacy data and analytics preferred.
• Experience with medical claims and medical data preferred.
• Experience in the management of oncology drugs.
• Experience with developing and implementing pharmacy quality & cost savings programs.
• Broad understanding of the health care delivery system, managed care and pharmacy benefit management.

Job Responsibilities:

a. Design and develop a long-term strategy for Wellmark’s specialty pharmacy program to support appropriate use of Specialty Drugs and measurably improve quality and affordability in both the medical and pharmacy benefit. Consult and engage with pharmacy team in an ongoing manner to seek input and secure buy-in.
An active and unrestricted Pharmacy license in Iowa or South Dakota (individual must be licensed in the state in which they reside) is required within 6 months from date of hire.
b. Monitor effectiveness of existing and new Specialty Drug Programs – and innovate and apply additional interventions to meet or exceed measurable quality and affordability goals.
c. Support core specialty clinical programs. Research and synthesize detailed clinical data related to specialty pharmaceuticals, including oncology drugs, to identify opportunities or impact.
d. Provide clinical consulting services and implement clinical information and education programs.
e. Analyze Specialty Drug and oncology drug spend and trend data and create mitigating strategies in response to trend.
f. Monitor Specialty Drug pipeline and evaluate the impact of new therapies.
g. Provide clinical guidance and support to various departments and address clinical related questions. Serve as a subject matter expert to help drive more proactive interventions of clinical and pharmacy trends.
h. Prepare and present therapeutic class reviews, drug monograph information, and recommendations for formulary management, utilization management, etc., for emerging therapies to the Pharmacy and Therapeutics Committee.
i. Work collaboratively with pharmacists and providers to meet the goals and objectives of the pharmacy program. Direct and support internal ad hoc pharmacy management projects, as well as projects with the contracted pharmacy benefit manager, as needed.
j. Provide insights and advise internal and external stakeholders on new and upcoming advances in pharmacy and the resulting impacts.
k. Manage clinical program implementations and ensure compliance with regulatory standards and accreditation standards.
l. Other areas of responsibilities include, specialty benefit design strategies, strengthening the specialty value proposition and presenting to internal and external stakeholders as requested.
m. Other duties as assigned.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com