Consulting - Pharmacist - Regulatory Insurance

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Part-time, project-based, consulting work

Position is work from home

Risk & Regulatory Consulting, LLC



Specific Duties and Responsibilities

  • Ensure issuer compliance of market-wide requirements of Title XXVII of the PHSA such as prescription drug formularies

  • Document in writing findings and reports of examinations, as needed.





  • Must have 5-10 years of pharmacy experience, as a registered pharmacist in regulatory, behavioral health, retail, and/or clinical

  • Advanced degree as PharmD or Bachelors of Science in Pharmacy with informatics background;  Previous experience with formulary medication systems development to support process improvement strategies;

  • 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 and 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

  • Must not currently be working with or have an affiliation with a managed care organization (MCO) which would create a conflict of interest

  • Mental Health Parity experience 

  • Experience with managed care expenses

  • Experience 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.

  • Ability to adapt to changing priorities, self-motivated and energetic qualities desirable.

  • Managed Care/Pharmacy Benefit Management and pharmacy audit experience a plus.

  • A combination of pharmaco-economic, drug information, clinical experience is highly desirable.

  • Must be comfortable doing presentations and conduct phone calls with multiple team members.

  • Travel as needed



You want your next step to be the right one. You've worked hard to get where you are today. And now you're ready to use your unique skills, talents and personality to achieve great things. RSM is a place where you are valued as an individual, mentored as a future leader, and recognized for your accomplishments and potential. Working directly with clients, key decision makers and business owners across various industries and geographies, you'll move quickly along the learning curve and our clients will benefit from your fresh perspective.

Experience RSM US. Experience the power of being understood.

RSM is an equal opportunity/affirmative action employer. Minorities/Females/Disabled/Veterans.
Job ID req4324
Line of Business: Consulting Services
SubFunction: RAS AML & Reg Compliance
Job Type: Full Time
Req #: req4324
Location: 1185 Ave of the Americas, , New York, NY US
Region: National
Job Category: Business Consulting/Technology
Employment Type: Experienced
Degree Required: Bachelor
Travel: No
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