EnvisionRxOptions - Twinsburg, OH

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EnvisionRxOptions, with a commitment to providing transparency and disclosure to the Pharmacy Benefit Management (PBM) marketplace, provides full service, integrated PBM services, including network-pharmacy claims processing, mail order, benefit design consultation, drug utilization review, formulary management, and other related services. If you are interested in becoming part of a team-oriented, fast-growing company we encourage you to consider a satisfying career at EnvisionRxOptions.

SUMMARY: The Clinical Pharmacist is responsible for supporting our Pharmacy and Therapeutics Committee and clinical functions of the company in accordance with the policies and practices of EnvisionRxOptions. This position will be responsible for working with the Director of Clinical Operations to develop and enhance services offered to our members in a variety of areas with emphasis on Medicare Part D, particularly in drug formulary development & Drug Therapy Management/Medication Therapy Management (MTM) programs while maintaining the exceptional level of professionalism and customer service standards that Envision has attained within the pharmacy benefit management industry.

  • Develop strategies to decrease pharmacy costs for members and the company
  • Review and process of Coverage Determination requests including prior authorization requests, quantity limit exceptions, tiering exceptions, and non-formulary exception requests
  • Monitor the impact of the Preferred Drug List (drug formulary) and prepare clinical drug reviews to determine utilization management guidelines
  • Provide clinical drug information and recommendations to appropriate committees
  • Aid the Director of Pharmacy in performing drug reviews, developing statewide and national clinical programs, and supporting utilization management
  • Analyze drug usage reports to identify problems and recommend solutions
  • Aid in the preparation and submission for Medicare formulary files includes HPMS submissions, marketing documents, web-based search files, etc.
  • Other duties as assigned
  • Bachelors degree in pharmacy or Pharm.D. required
  • A valid pharmacist license in the state of California, Florida or Ohio required
  • A knowledgeable individual with appropriate industry experience, preferably in the healthcare, insurance or PBM industry
  • At least two to five years of general pharmacy or pharmacy benefit management experiences
  • Knowledge and experience in Medicare Part D
  • An intelligent and articulate individual who can relate to people at all levels of an organization and possesses excellent communication skills
  • A strategic planner with sound technical skills, analytical ability, good judgment and strong operational focus
  • Ability to work with peers in a team effort
  • Ability to work extended hours, weekends and holidays pursuant with industry demands
  • Working knowledge of clinical and formulary issues
  • Effective verbal and written communication skills
  • Proficient in Microsoft Office and industry related software programs

Pre-employment drug screening and background checks are required. The company offers a competitive salary and benefits package. EOE

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