Pharmacy Management Consultant
Posted on Apr 5, 2021 by Milliman
The Pharmacy Management Consultant will be developing and delivering innovative, market-leading strategy that will encompass various markets and pharmacy stakeholders while being able to learn from other subject matter experts within the cross-functional team.
Use pharmacy clinical and financial knowledge to diagnose and solve client problems in a managed care setting.
Design and deliver innovative strategic support to clients by developing proposals, creating presentations, and delivering innovative, market-leading recommendations to clients.
Serve as a subject matter expert of pharmacy reimbursement strategy with payer clients and pharmaceutical manufacturers.
Create new and expand upon existing consulting relationships with health plans, PBMs, pharmaceutical manufacturers, and other entities of the pharmacy supply chain.
Potential projects could include:
Medicare Part D, Medicaid, and/or commercial pharmacy formulary analyses
Evaluation of pharmaceutical pipeline and development of a cost management strategy (eg, evaluating impact of drugs seeking regulatory approval for non-alcoholic steatohepatitis, oncology, heart failure, etc.)
Pharmaceutical manufacturer product strategy (eg, analytics to support formulary negotiations and assessing the impact of regulatory changes on the current reimbursement environment)
Strategic support in pharmaceutical M&A or joint venture.
5+ years working experience, preferably at a consulting firm, PBM, managed care organization, health plan, or pharmaceutical company.
Experience working with Medicare, Medicaid, and/or commercial payers.
Experience solving complex problems with innovative, creative solutions.
Experience working with large pharmacy claims data sets.
Experience designing and optimizing pharmacy benefits, including analyzing the impact of discounts, rebates, and program changes (eg, formularies, networks, clinical programs).
Deep understanding of pharmacy purchasing and reimbursement environment including pharmacy cost metrics such as average wholesale price, wholesale acquisition costs, average sales price, actual acquisition costs, and rebates.
Strong sense of accountability and business acumen.
Bachelors or doctorate degree in pharmacy and active Pharmacist licensure.