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RSM US LLP Consulting - Regulatory Insurance - Pharmacist Consultant in Minneapolis, Minnesota

Pharmacist Consultant Position is work from home Risk & Regulatory Consulting, LLC Specific Duties and Responsibilities: Assess issuer/insurer compliance with market-wide requirements of ACA, MHPAEA, and state laws, including prescription drug formularies and design thereof and pharmacy claims benefits, including mandated benefits. Experience with PBMs a plus Document in writing findings and reports of examinations, as needed Prepare and present training on such topics Participate in practice development activities with state and federal state agencies Requirements: Must have 15+ years of pharmacy experience as a registered pharmacist in the regulatory, insurance or healthcare industry or consulting industry, behavioral health, retail and/or clinical fields. Must have 10+ years of Pharmacy Benefits Management (PBM) experience PharmD is required Strongly prefer candidates with state insurance or state health agency experience, CMS (Center for Medicare and Medicaid Services) and/or Office of Personnel Management experience Must have experience with formulary reviews, pharmacy claims audits, auditing formularies and experience with formulary medication system Experience running CMS formulary tools is a must along with review of formulary filings with state and federal agencies Previous experience with formulary medication systems development to support process improvement strategies is helpful Effectively use information technology (IT) to analyze data in areas of evidence based medicine practices, outcomes measurements, and process improvements Must be able to interact with multi-disciplinary team of experts in areas of IT, health insurance, pharmacy, market regulation and healthcare policy Must understand the fundamentals of pharmacy financial data and balancing clinical, regulatory, pharmaceutical industry and consumer access issues to formulary system development Must be able to contribute decision support for system refinements pertinent to improving formulary review, optimizing review tools, and enhancing system performance. Claims processing experience in retail or managed care ACA and Mental Health Parity experience Experience with managed care RX expenses Proficient at using Microsoft Office (Word, Excel, Access, PowerPoint, and Outlook) Effective written and oral communication skills Must be able to meet tight deadlines and offer flexibility in hours Regulatory experience is a plus Strong writing skills Strong analytical abilities and attention to detail Experience and ability to work both independently and within a team environment - strong team player desired Ability to adapt to changing priorities, self-motivated and energetic qualities desirable Managed Care/Pharmacy Benefit Management and pharmacy audit experience preferred A combination of pharmaco-economic, drug information, clinical experience is highly desirable Must be comfortable doing presentations and conducting phone calls with multiple team members Travel as needed **When applying please add your resume as an attachment!** Please do not auto generate resume from LinkedIn Risk & Regulatory Consulting, LLC (RRC) was formerly a business segment of RSM US LLP (formerly McGladrey) until 2012 when the separate legal entity was formed. RRC is a strategic business partner with RSM providing actuarial and insurance industry consulting services to RSM clients. Risk & Regulatory Consulting, LLC (RRC) is a national, leading professional services firm dedicated to providing exceptional regulatory services to clients. With over 100 experienced insurance professionals located in 22 states, we believe RRC is uniquely positioned to serve state insurance departments. We offer services in the following regulatory areas: financial examinations, market conduct examinations, insolvency and receiverships, actuarial services and valuations, investment analysis, reinsurance expertise, market analysis and compliance, and special projects. We