Clinical Formulary Pharmacist

Define and develop standard and custom formularies across commercial, Medicaid, Medicare Part D, and the Health Information Marketplace. Assess drug use trends and primary literature to produce formulary and drug product review recommendations. Analyze pharmacy cost of care, create clinical criteria for prior authorization and non-formulary decisions, and develop clinical edits to improve claim adjudication. Support P&T Committee processes and guide pharmacy technicians with clinical guidance and documentation.