Managed Care Pharmacy Residency Program

Residency Program Responsibilities and Outcomes

1. ✓ Evaluate member formulary disruption and provide transition recommendations for new pharmacy benefit clients and maintenance formulary changes.
2. ✓ Understand and resolve member/client medication issues while collaborating with the EpiphanyRx Account Management team.
3. ✓ Analyze clinical strategy for new drugs, biosimilars, generics and new formulations, including prior authorization criteria.
4. ✓ Participate in formulary management from Medi-span drug updates, Formulary Advisory Committees, and Pharmacy and Therapeutics Meetings.
5. ✓ Identify specialty medications, unique management strategies around them, and engage with Lumicera pharmacists to facilitate EpiphanyRx cases.
6. ✓ Understand the benefits of a medical carve-out program and what drugs are commonly included on a medically administered formulary.
7. ✓ Draft client facing and member centric clinical and formulary communication materials.
8. ✓ Assist in preparing for and presenting client quarterly reviews.
9. ✓ Conduct cost-effective analysis for new high-cost specialty drugs.
10. ✓ Become familiar with pharmacy claims adjudication and benefit configuration set-up.
11. ✓ Present a clinical in-service topic monthly to the EpiphanyRx team.

Areas of Learning

• Clinical Account Management
• Pharmacy Operations
• Formulary and Utilization Management
• PBM Administration
• Specialty Pharmacy
• Data and Clinical Analytics
• Trend Reporting and Management
• Drug Information