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Centene Corporation Clinical Pharmacist in Getzville, New York

Position Purpose:

Define and develop standard and custom formularies for assigned plan.

  • Develop clinical criteria for review of medications, recommend plan design changes and communicate recommendations to clients

  • Monitor and review prior authorization requests for medications

  • Develop and design clinical edits to adjudicate claims and enhance drug utilization

  • Analyze pharmacy cost of care, trends, and coordinate the development of appropriate use protocols and guidelines

  • Set criteria for medication analysis, coordinate reports to clients, meet regulatory reporting requirements for drug utilization review and fraud and abuse reporting

  • Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews

  • Participate in the development and implementation of medication therapy management programs

  • Provide clinical guidance and support to various departments and address clinical related questions


Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.Licenses/Certifications: Current state’s Pharmacist license with no restrictions. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. TITLE: Clinical Pharmacist LOCATION: Getzville, New York REQNUMBER: 1239479 COMPANY: Clinical & Care Management POSITION TYPE: Both