Pharmacy Integrity Specialist

18 hours ago

Melbourne, Victoria, Australia beBeeRegulatory Full time $120,000 - $150,000
Pharmacy Integrity Specialist

About the Role:

This is a key position within our organization, responsible for ensuring the safe and effective delivery of pharmaceutical benefits. The Pharmacy Integrity Specialist will oversee the implementation of pharmacy policies and practices that align with regulatory requirements and company goals.

The ideal candidate will have a strong foundation in pharmacy practice and a strategic mindset. They will possess excellent communication skills and be able to work effectively across senior leaders, clinicians, and operational teams.

Key Responsibilities:

  • Manage and maintain the Drug Database and related collateral, ensuring medications listed for reimbursement align with Pharmacy and Product Policies.
  • Provide expert pharmaceutical advice to product teams, ensuring compliance with private health insurance legislation and regulations.
  • Ensure adherence to PBS, TGA, and other regulatory standards relating to drug coverage and reimbursement.
  • Review and assess high-cost drug claims for alignment with hospital agreements and health insurance policies.
  • Analyse pharmaceutical data to identify trends, risks, or potential claims leakage.
  • Advise the hospital contracting team on high-cost drug clauses during contract negotiations, offering insights into pricing, reimbursement models, and regulatory requirements.

Required Skills and Qualifications:

  • Registered Pharmacist with a Bachelor of Pharmacy (or equivalent).
  • 5+ years' experience across clinical, hospital, community, or industry settings.
  • Strong knowledge of high-cost medicines, funding frameworks, and relevant regulations (PBS, TGA, private health insurance).
  • Strategic thinker with the ability 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 (e.g. Masters, MBA, Health Economics) desirable.

About You:

We are looking for a highly skilled and experienced individual who can make a significant impact in this role. If you have a passion for pharmacy and a desire to work in a dynamic environment, we encourage you to apply.

Career Benefits:

This role offers a unique blend of clinical expertise and strategic leadership. As a Pharmacy Integrity Specialist, you will have the opportunity to contribute to the development of health insurance products and ensure the safe and effective delivery of pharmaceutical benefits.

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