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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medication management, drug utilization reviews, and clinical pharmacy operations while ensuring compliance with regulatory standards. Strong communication and problem-solving skills are essential for engaging with members and providers effectively.
Highest-signal resume keywords
Pharmacy DegreeState Pharmacy LicenseMedication Therapy ManagementClinical Pharmacy OperationsManaged Care Residency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Drug Utilization ReviewComprehensive Medication ReviewFormulary CompliancePrior Authorization ReviewClinical Policy DevelopmentPharmacy & Therapeutics Committee ResearchMedication Therapy RecommendationsUtilization ManagementClinical Outcomes AnalysisTechnology-Enabled Processes
Soft Skills
EmpathyDetail-OrientedEffective Problem-SolvingGood ListeningAbility to Influence
Certifications & Qualifications
PharmD PreferredMulti-State Licenses Preferred
Industry Keywords
PBM Clinical OperationsHealth Plan Pharmacy DepartmentConcierge ExperienceHolistic Member SupportClinical Pharmacy Strategy
About the role
Key responsibilities & impact- Guide members in managing medications and disease states as the “Pharmacist in the Family”
- Engage members by phone, chat, and email to provide a white-glove/concierge experience
- Answer member questions about pharmacy-related topics
- Perform prospective and retrospective drug utilization reviews and comprehensive medication reviews
- Recommend changes to patients’ drug regimens
- Partner with Rightway’s Navigation team to provide holistic member support
- Engage providers regarding medication therapy gaps, drug therapy recommendations, formulary compliance, and medication expertise
- Contribute to Pharmacy & Therapeutics committee research, drug monographs, therapeutic category reviews, and clinical policy development
- Support prior authorization reviews related to drug selection and formulary compliance
- Perform utilization management reviews and outreach to members and providers for clinical and cost-savings outcomes
- Collaborate with third parties on Rightway’s clinical pharmacy strategy
- Achieve productivity and quality metrics for clinical pharmacy interactions
- Contribute to technology-enabled processes for a scalable clinical pharmacy operation
- Ensure regulatory standards are consistently met
Requirements
What you’ll need- Pharmacy degree required; PharmD preferred
- 3 years in direct patient care such as PBM clinical operations, Health Plan Pharmacy Department, or Medication Therapy Management services
- State pharmacy license required in the state of residence
- Multi-state licenses preferred and/or willingness to attain licensure in additional states
- Managed Care or other pharmacy residency preferred
- Empathetic, detail-oriented, intellectually and clinically curious, good listener, and ability to challenge the status quo
- Effective problem-solving and prioritization skills; ability to manage through change
- Solid communication skills
- Ability to lead projects and influence others without direct reporting-line ownership
Benefits
Comp & perks- Bonus
- Equity
- Occasional travel may be required