Clinical Pharmacist (CCE – Drug Risk) at Discovery Limited April, 2025

Key Purpose

• The purpose of this role is to support design, implement, and manage drug benefits, including price negotiation and clinical coding. The clinical pharmacist will support the development of benefit rules, conduct research, evaluate products, validate claims, support stakeholders, assist with policy decisions, analyse data, and stay updated on clinical developments.

Areas of responsibility may include but not limited to

• Drug Benefit Design Support for DHMS and In-House schemes (E.g. Formularies, Medicine reference pricing)
• Price negotiation support – pharma liaison, price negotiation support for all benefits
• Utilisation of drug product price files with clinical coding and benefit groupers for assistance with and involvement in:
• Drug Benefit Rule development, enhancement and maintenance.
• Clinical research and product evaluation for Drug formularies and drug claims validation rules
• Drug benefit and policy documentation
• Pharmaceutical coding analysis for new drug benefit design
• Drug Strategy and project support
• Internal stakeholder support with drug benefits and rules
• Drug Benefit Rule support to the internal PBM as well as assistance with PBM queries
• Keeping up to date with new clinical developments [e.g. new drugs, protocols, guidelines etc.]
• Support to the policy and HTA team regarding reimbursement and benefit decisions
• Drug claims data analysis supporting risk management projects and strategies.
• Clinical tool development including clinical coding crosswalks for drug risk management and monitoring
• Adhoc tasks as required.

Personal Attributes and Skills

The following competencies are required to be successful in the role:

• Self-driven and motivated
• Assertiveness
• Resilience
• Strong analytical and problem-solving skills
• Highly developed writing and communication skills
• Time management and planning/organisational skills
• Attention to detail and process management
• Stress management
• Teamwork
• Strong customer focus
• Ability to work extended hours when necessary and within timelines
• Change management and multi-tasking skills

Education and Experience

Education

• Matric
• Professional Pharmacist (4-year degree)
• Post Graduate Pharmacy Degree is advantageous

Experience

Minimum 2-3 years Managed Health Care experience in the following areas:

• Drug formulary development/management/implementation (Essential)
• Therapeutic drug class database knowledge (Pharmaceutical and Industry drug coding) (Essential)
• Drug reference pricing experience in formulary and benefit design (Essential)
• Pharmaceutical coding experience e.g. WHO ATC classification (Essential)
• Drug Utilisation Review and Protocol Development
• Pharmacy Benefit Management (PBM) experience in Drug Benefit Rule  
• Implementation/Management (Acute and Chronic)
• Drug risk profiling /reporting experience an advantage