• Maintain current knowledge of drug therapies and drug reactions and interactions by reading professional literature, attending seminars and through professional affiliations.
• Provides clinical expertise and drug information to meet the needs of Clients and clinical staff members through direct contact or consulting.
• Participate in meetings, maintaining familiarity of required materials for Clinical Advisory Board CAB Committee meetings.
• Participate as an active member of assigned Clinical Advisory Board CAB Committees.
• Support and implement Client focused P&T committee/plan formulary changes, recommendations, quantity limitations and other clinical initiatives internally (i.e., systems, operations, account managers, customer service) and as otherwise instructed.
• Work with Client medical directors and staff in developing and carrying out various clinical initiatives.
• Assist in the development, preparation, build, testing and management of custom formularies, preferred drug lists prior authorization criteria and step therapy protocols.
• Attend and participate in other programs, committees, meetings, and functions as required.
• Assist in plan set-ups regarding formularies, quantity limits, prior authorizations for on-line adjudication.
• Work with internal and contracted clinical pharmacists in the development, implementation, and coordination of physician and patient educational materials and programs.
• Assist with coordinating mentoring opportunities for the team
• Facilitate meetings by coordinating arrangements and preparing agenda including coordination of video/conference calls
• Assist in the generation, maintenance and distribution of formulary alternative lists, maintenance drug lists, and new drug to market lists.
• Assist with managing clinical compliance with Government programs & requirements.
• Assist in the review of new drugs entering market and potential implication of drug costs and report the findings to management and coordinating necessary changes such as adding to new to market lists, PA lists, quantity limit lists, “Me Too List”, etc.
• Work cooperatively with other staff members to enhance the team concept.
• Promptly report any allegations of impropriety to the Compliance Department.
• Comply with Maxor’s Ethical Business Conduct policy and Maxor’s Compliance Program.
• Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists.
• Complete required training.
• Must be able to cope with the mental and emotional stress of the position.
• Promote teamwork
• Maintain regular attendance in accordance with established policies.
• Perform other job-related duties as assigned.

• Self-starter and high-performing individual
• Exceptional analytical and critical thinking skills
• Ability to understand comprehensive the PBM environment and broader health care system
• Has comprehensive understanding of PBM pricing, network, eligibility, clinical/drug structures such as Prior Authorization, Step Therapy, Formulary lists, Mail Order.
• Has comprehensive knowledge of the claims processing, hierarchy of adjudication systems
• Exhibits ability to manage benefits system implementation, products and drug programs, mentoring team members when new products or processes are implemented
• Able to successfully interface across departments
• Able to analyze issues/problems from multiple perspectives while anticipating and developing benefit solutions for new and existing programs
• Ability to organize, prioritize, and schedule work assignments.
• Ability to communicate effectively, both verbally and in writing.
• Good computer skills in general with the ability to learn new software programs and applications
• Ability to clearly communicate medical information to professional practitioners and/or the general public.
• Skill in examining and re-engineering operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
• General knowledge of budgeting, cost estimating, and fiscal management principles and procedures.
• Change Agent
• Ability to handle multiple tasks
• Working knowledge of Microsoft Office products
• Communicates effectively with internal and external customers
• Identifies areas for improvement as appropriate
• Possess strong organizational skills
• Strong interpersonal and communication skills

• Comprehensive mental health and wellbeing resources
• Nationwide Blue Cross Blue Shield PPO with employee friendly plan design, including $850 individual annual medical deductible, $25 office visit copays, Low biweekly premiums
• Company paid basic life/AD&D, Short-term and Long-term disability insurance
• Rx, dental, vision, short-term disability, and FSA
• Employer-matched 401k Plan
• Industry leading PTO plan
• And MORE!

Please apply online at: https://careers-maxor.icims.com/