Job Description

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary
We are seeking a clinical pharmacist with a focus on industry relations. The domain expertise requires both foundational clinical pharmacy experience alongside an interest and passion for partnering closely with pharmaceutical and biotechnology companies, and other vendor partners who engage in contracting opportunities such as rebate management, and clinical programs. Overall, this position is responsible for supporting formulary and policy development, driving to the lowest net cost which are supported by our clinical strategies, and articulating this value as necessary to key stakeholders. This position includes reviewing rebate initiatives for medications covered under the pharmacy and medical benefits, across various lines of business including commercial, Exchange, Medicare and Managed Medicaid. The role includes facilitating or supporting the implementation of projects or activities with both external and internal stakeholders. The ideal candidate resides near or within commuting distance of our Portland, Oregon office to support a hybrid work arrangement, however, remote status will also be considered. 

Pay Range
$111,640.18 - $142,337.61 annually (depending on experience)
*This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.

Benefits :

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Required Skills, Experience & Education:

• Doctor of Pharmacy degree (Pharm.D.) preferred.
• Current active and unrestricted Oregon Registered Pharmacist license, or eligible for Oregon licensure which is to be obtained within 60 days of hire date.
• Two to three years of managed care experience or training from an accredited managed care residency program.
• Strong analytical skills and business acumen.
• Ability to communicate and present technical information appropriate for the audience.
• Ability to work independently and collaborate cross-functionally with various stakeholders.
• Project management skills and the ability to plan and execute projects as assigned.
• Commitment to service, organization values, and professionalism through appropriate conduct and demeanor always.
• Ability to maintain confidentiality and project a professional business image.
• Works well under pressure with frequent interruptions and shifting priorities.
• Strong written and verbal communication skills.
• Proficient with Microsoft Word, Excel, Outlook, and PowerPoint.

Primary Functions :

• Obtain and review rebate offerings for existing therapeutic strategies which support ongoing formulary performance but also identify new opportunities either as contracting changes or new market entrants are FDA-approved.
• Work closely with vendor partners (PBM, medical management companies, others) on policy or formulary changes driven by cost analysis, including rebate considerations or contracting.
• Request and identify medical and pharmacy rebate management across all lines of business (i.e. commercial, Exchange, Managed Medicaid, custom clients, and Medicare as needed).
• Support and/or lead client facing presentations within industry relations as necessary.
• Responsible for information gathering with legal and/or regulatory teams to understand impact to current formulary strategies, with financial implications, to anticipate or plan for any potential compliance driven update due to changes in existing, or new and emerging states of business.  
• Monitor, anticipate changes, and prepare for pipeline and market events.
• Develop concise, applicable, comprehensive, and timely communiques as assigned for members, providers, internal, or external stakeholders.
• Provide clinical support services that intersect industry relations or business development, including but not limited to benefit design, formulary analysis, drug information, P&T participation, client support, and drug utilization management.
• Provide clinical expertise with a focus on industry relations to all key stakeholders, including Senior Rx Program Analyst, Clinical Pharmacy, Benefits, within or outside of pharmacy. For example, specific to analyst level support, provide clinical expertise for indication-based dosing and defining therapeutic landscape.
• Contribute, update, and maintain policies and procedures related to industry relations.
• Lead as needed, from both a clinical pharmacy and industry relations perspective, weekly drug compendia formulary management file.
• Complete significant projects and performs all other related duties as assigned.
• Follow the company HR policies, Code of Conduct, and all department policies and procedures including protecting confidential company, employee, and customer information.

Working Conditions & Contact with Others

• Remote, office environment, and/or hybrid with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business needs. May require occasional travel to conferences or offsite business meetings.
• Internally with Clinical Pharmacy, Marketing, Sales & Account Services, Actuary & Underwriting, Healthcare Services, Customer Service, Information Technology, Benefits, Regulatory Affairs, Legal, and Membership Accounting.  Externally with PBM, medical management vendor, pharmaceutical and biotechnology manufacturers, producers, benefit managers, clients, providers, and pharmacists.

 

Together, we can be more. We can be better.

 
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. 

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.

Job Tags

Hourly pay, Full time, Work at office, Remote work, Shift work, Afternoon shift,

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