Clinical Pharmacy Strategist

2 weeks ago

Melbourne, Victoria, Australia beBeePharmaceutical Full time $100,000 - $123,000

Healthcare Excellence Leader

This role plays a critical part in ensuring safe and effective pharmaceutical benefits delivery within the organisation. As a member of the Claims Integrity & Provider Capability Transformation (IC&PCT) Leadership Team, you will oversee pharmacy policy implementation, aligning with regulatory requirements and company goals.

You will work closely with internal teams and stakeholders to optimise pharmaceutical benefits, manage medication-related risks, and maintain an accurate drug database for compliance with policies and regulations. Additionally, this role involves providing guidance on high-cost drug requests and supporting initiatives aimed at improving health outcomes and controlling pharmacy-related costs.

Through strategic leadership and expert pharmaceutical guidance, the Pharmacy Manager enhances the overall value of health insurance offerings, ensuring members have access to appropriate and affordable medications.

About the Role

This is a full-time, permanent position offering a hybrid work arrangement with occasional office visits.

The ideal candidate will blend clinical expertise in pharmacy with corporate knowledge of healthcare, managing tasks such as:

  • Maintaining the Drug Database and related collateral to ensure aligned medication reimbursement.
  • Providing expert pharmaceutical advice to product teams, ensuring compliance with private health insurance legislation and regulations.
  • Ensuring adherence to PBS, TGA, and other regulatory standards relating to drug coverage and reimbursement.
  • Reviewing and assessing high-cost drug claims for alignment with hospital agreements and health insurance policies.
  • Analysing pharmaceutical data to identify trends, risks, or potential claims leakage.
  • Advising the hospital contracting team on high-cost drug clauses during contract negotiations, offering insights into pricing, reimbursement models, and regulatory requirements.
About You

As a Registered Pharmacist with a strong foundation in pharmacy practice, you bring a strategic mindset that extends beyond day-to-day operations. Your skills include:

  • 5+ years' experience across clinical, hospital, community, or industry settings.
  • Strong knowledge of high-cost medicines, funding frameworks, and relevant regulations.
  • Strategic thinker able to challenge the status quo and shape forward-looking initiatives.
  • Skilled communicator with proven influence across senior leaders, clinicians, and operational teams.
  • Adaptable problem-solver who thrives in complex environments.
  • Self-starter with a strong delivery focus; postgraduate qualifications desirable.

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