Our organisation is seeking to recruit highly qualified and experienced individuals to join our dynamic and professional team. Applications are invited from suitably qualified and experienced candidates for the following position:
PHARMACY BENEFITS MANAGEMENT SPECIALIST
The Position
Reporting to the Utilisation Management Specialist, the position shall be responsible for the following, among other duties:-
Advises on adjudication, reimbursement and pricing of pharmaceutical claims rules in line with our organisation’s strategy;
Provides member support through member education on formulary and plan benefits, prior authorization process, and coordinates with other network pharmacies to address member concerns related to pharmacy benefits;
Develops evidence based formulary that is appropriate for the organisation’s benefits structure;
Leads in reference pricing of specific drug classes to appropriate generic or reference agents;
Designs appropriate oncology pharmaceutical programme that is in line with the benefit design and underpinned by local and international on cology guidelines;
Responsible for the formulation and implementation of the medicines optimization strategy;
Profiles diseases of patient groups and make risk adjustment in line with their disease coding and pharmaceutical prescribing patterns;
Proactively reports on new therapies, prescribing trends and future risks.
Person Specifications
A level passes;
A Bachelor of Pharmacy Degree or equivalent;
Postgraduate qualification of Master of Public Health or Health Economics is an added advantage;
At least 5 years’ experience in healthcare management;
Exposure to pharmacy benefits management is also an added advantage;
Highly computer literate;
Good interpersonal skills.
Job Summary
More Information
- Job Application Details If you are qualified and interested, please submit your application together with your detailed CV by not later than Friday 19 March 2021 to [email protected]