Medical Representative

Job Summary: We are seeking a detail-oriented and clinically knowledgeable Clinical Pharmacy Analyst / PBM Liaison to support our pharmacy operations team with a strong focus on back-end clinical processes and collaboration with our Pharmacy Benefit Management (PBM) partners. This role involves analyzing pharmacy claims data, supporting formulary management, and ensuring clinical alignment with PBM strategies and policies. While this position will interface with PBM representatives, the majority of responsibilities will be behind-the-scenes and pharmacy-focused. Key Responsibilities: Act as a liaison between internal pharmacy/clinical teams and external PBM partners. Support formulary development and management, including drug evaluation, utilization trends, and evidence-based reviews. Collaborate with the clinical team on therapeutic class reviews, prior authorization criteria, and step therapy protocols. Analyze pharmacy claims data to identify trends, gaps, and opportunities for cost containment and improved patient outcomes. Assist with implementation and monitoring of clinical programs such as medication therapy management (MTM), adherence initiatives, and disease management programs. Provide clinical support for contract management and review of PBM deliverables, including performance guarantees and rebate programs. Prepare and present clinical data and reports to support internal decision-making and external discussions with PBMs. Support audit preparation and ensure compliance with regulatory requirements related to pharmacy benefits. Required Qualifications: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy (BPharm) degree required. Active pharmacist license (preferred but not always required depending on scope). 25 years of experience in a clinical pharmacy setting, health plan, PBM, or similar managed care environment.