Job Description

Description

Pharmacist Consultant

KAI Partners Inc. (KAIP) is currently seeking a Pharmacist Consultant to serve as a subject matter expert providing clinical guidance regulatory insight and data-driven expertise across pharmacy and healthcare initiatives. This role combines strong clinical pharmacy knowledge with advanced analytical skills to interpret complex data generate executive-level summaries and support compliance effortsparticularly during legislative and regulatory bill cycles.

The Pharmacist Consultant will evaluate clinical and operational pharmacy initiatives analyze performance and utilization data interpret regulatory impacts and translate findings into actionable recommendations for leadership and stakeholders. This individual will play a critical role in ensuring that pharmacy programs align with federal and state regulations CMS guidance and evolving healthcare legislation.

Responsibilities

• Provide regulatory guidance related to CMS Medicaid Medicare HIPAA and other applicable healthcare frameworks.
• Collaborate with policy legal IT analytics and operations teams to translate regulatory and clinical requirements into actionable implementation steps.
• Assist in drafting policy analyses legislative summaries and fiscal impact considerations related to pharmacy services.
• Support the review and validation of pharmacy-related business rules claims adjudication logic and clinical criteria.
• Develop clear concise data summaries executive briefings dashboards and reports to support internal leadership and client decision-making.
• Interpret state and federal legislation during bill season and assess potential impacts to pharmacy programs reimbursement structures and compliance requirements.
• Participate in stakeholder meetings to provide clinical interpretation of data findings and regulatory considerations.
• Ensure documentation and processes align with compliance standards and audit readiness requirements.
• Provide subject matter expertise during project planning implementation and post-implementation review phases.
• Perform other duties as assigned.

Skills and Qualifications

• Active Pharmacist license (RPh or PharmD) in good standing.
• Strong clinical knowledge across therapeutic classes formulary management and pharmacy benefit structures.
• Advanced analytical skills with the ability to interpret large datasets identify patterns and translate findings into strategic insights.
• Ability to synthesize complex regulatory and legislative language into clear operational implications.
• Strong understanding of state and federal pharmacy regulations including CMS Medicaid Medicare Part D and HIPAA requirements.
• Experience reviewing and summarizing proposed legislation regulatory guidance and policy changes.
• Excellent written and verbal communication skills with the ability to present complex clinical and data-driven information to both technical and non-technical audiences.
• Strong critical thinking problem-solving and independent judgment skills.
• Ability to manage multiple initiatives in a fast-paced dynamic consulting environment.
• Experience working cross-functionally with clinical technical and policy teams.
• High attention to detail especially in compliance reporting and regulatory documentation.

Work/Education Experience

• Doctor of Pharmacy (PharmD) from an accredited institution. (Preferred)
• Active and unrestricted Pharmacist license. (Required)
• 58 years of relevant experience in clinical pharmacy managed care PBM operations Medicaid/Medicare programs or healthcare consulting.
• Experience analyzing pharmacy claims data and preparing executive-level summaries and reports.
• Experience with Medicaid Medicare CMS regulations or state healthcare programs strongly preferred.
• Experience supporting regulatory analysis or legislative impact assessments is highly desirable.
• Experience with pharmacy benefit platforms claims systems MMIS or health IT systems preferred.
• Advanced degree (MPH MBA MHA) or board certification (e.g. BCPS) preferred.

Compensation Range: $135000 - $175000

The salary range for this role may vary depending on the specific geographic location where this position is ultimately filled. Several factors including but not limited to a candidates experience education skills and certifications pay equity and organizational needs are considered when determining the posted salary addition eligible roles also qualify for a comprehensive benefits package.

Must be able to provide proof of education for all mandatory qualifications; all references will be verified.

All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity or national origin.

KAI Partners

KAI Partners Inc. is a Northern California-based small business that offers world-class management consulting and technology services to public and private sector clients on a variety of large-scale projects. The KAI Partners team has over 100 years of combined executive-level experience in information system design development implementation and testing. Our clients benefit from our proven program management project management and oversight program portfolio management Agile services organizational change management training enterprise architecture managed IT service and IT security support.

Experience:

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