Pharmacist Consultant (Pharmacy Benefit Management Subject Matter Expert)

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Responsibilities

The Pharmacist Consultant works in a team environment on government client pharmacy benefit manager (PBM) audits and audit related consulting engagements to validate the integrity and accuracy of the administration of pharmacy benefit programs. This includes all aspects of contracted services including pricing adherence, formulary management, performance guarantees, rebate administration, and operational functions of the PBM.

Essential Functions and Primary Duties

• Perform pharmacy benefit related performance audits of government clients and health plans
• Participate in client meetings to obtain key benefit facts and documentation for the audits
• Collaborate in a team-based environment to perform the audits using a variety of analytical processes and claims data validation techniques
• Examine and validate initial analysis output
• Communicate and engage with the audited PBM to jointly review initial findings and assess any variances or discrepancies
• Prepare and review reports and workbooks of the audit outcome for clients
• Maintain security and confidentiality of all protected health information encountered during performance and other essential functions
• Participate in meetings, team projects, and discuss current topics with clients
• Collaborate with staff and listen and communicate effectively
• Additional responsibilities as assigned

Preferred Qualifications

• Pharmacy degree from ACPE – accredited pharmacy school
• Must have and preserve an active pharmacy license (any state)
• 6 + years of relevant work experience
• Minimum of 3 years of pharmacy managed care or prescription benefits management (PBM) experience required
• Well organized with a high degree of accuracy and attention to detail
• Strong analytical and problem solving skills, working knowledge of SQL a plus
• Demonstrated ability to communicate verbally and in writing with all levels of the organization, both internally and externally
• Effective in multi-tasking with planning and efficiency
• Proficient use of applicable software programs, including Microsoft Word, Excel, and PowerPoint
• Ability to function within a team environment as well as work independently
• Self-motivated with a strong work ethic
• Ability to travel overnight occasionally to client sites and regional offices

Qualifications

Minimum Qualifications

• High school diploma or GED

Myers and Stauffer LC is a certified public accounting and health and human services consulting firm, specializing in audit, accounting, data management and consulting services to government-sponsored health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45+ years of experience assisting our government clients with complex health care reimbursement and provider compliance issues, operate 21 offices and have over 900 associates nationwide.

At Myers and Stauffer, you will have a career that is rewarding while also supporting our state and federal government health and human service clients that focus on those in need. We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team. Our firm takes pride in the welcoming and collaborative culture we have throughout our offices.  We are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing.

What We Offer:

We understand that changing or learning a new industry can discourage strong candidates from applying. Please do not hesitate to apply, as you may be the right fit for this position or another position we have open.