Pharmaceutical Governance

To manage, execute and complete specific deliverables and activities that ensure the effectiveness of the pharmaceutical projects and activities through providing accurate pharmaceutical information, conducting pharmaceutical analysis and medications’ utilization review, managing the pharmaceutical cases and Govern the PBM. This Governance is important to ensure providing appropriate decisions as well as using of accurate medications’ data by Bupa Arabia staff to achieve the best clinical outcomes and cost-effective care for Bupa members

**Bupa Drug Formulary Management and Medications Database**
- Develop, maintain, and manage Bupa Drug Formulary.
- Ensure the update of the formulary according to the best clinical practice, SFDA and CHI recommendations.
- Develop and manage the coverage status and therapeutic coverage criteria of each medication.
- Identify branded medications with their alternatives and classify them to provide deductible % for each medication.
- Manage the technical aspect of Bupa Formulary on the system and Intranet (upload, addition, deletion and amendments—etc).
- Design different formularies lists that can include multiple tiers to promote the use of clinically appropriate, cost-effective, lower-cost generic medications.
- Manage and update the coding systems of medications (e.g GTIN, SFDA, Scientific codes - etc)
- Manage and maintain medications’ database

**Medications’ utilization Review**
- Design data models that integrate patient data from multiple sources to create complete views of pharmaceutical data.
- Develop quantified waste for medications errors, overutilization, inappropriate clinical and pharmaceutical management.
- Conduct retrospective pharmaceutical statistical analysis on yearly basis for all medications.
- Monitor and perform in-depth analysis of pharmaceutical claims and PA data to identify trends and opportunities for improvement.
- Conduct feasibility and impact studies for the clinical and cost management initiatives.
- Deliver quarterly pharmaceutical reports for mega accounts to monitor their medications utilization.
- Conduct and/or validate all pharmaceutical studies/analysis for other business units.
- Report the outcomes of Medications’ utilization management and provide a proper recommendations to the business

**Drug Information Management - Therapeutic effectiveness**
- Search for the best practices of new trends in pharmaceutical field by using trust therapeutic resources and tools.
- Establish therapeutic guidance for the medical staff according to the business needs.
- Respond to all pharmaceutical queries, CHI pharmaceutical complex cases effectively.
- Revising any pharmaceutical content for Bupa Arabia staff.
- Responsible to manage Pharmaceutical Educational Activities.
- Manage the communications with the pharmaceutical companies as the primary contact person

**PBM Governance**
- Ensure compliance with regulatory requirements and pharmaceutical standards.
- Lead the evaluation, and maintenance of pharmaceutical/clinical drug edits
- Audit and assess the effectiveness of PBM rules.
- Classify medications according to PBM categorization

**Pharmaceutical Care Programs and Specialty pharmaceutical Management**
- Develop and utilize the decision-making approach in pharmaco-economics
- Collecting the medical requirements
- Analysing the clinical / medications’ data
- Evaluate the case according to the therapeutic guidelines and best practices.
- Revising and evaluation of the therapeutic outcomes before and after the patient has received the medication

**Skills**:

- Intermediate to advanced skill level with MS Excel and PowerPoint
- Intermediate to advanced skill level with MS Excel and PowerPoint
- Data analysis including healthcare claims data manipulation
- Ability to interpret both high level and detailed view of the data
- Intermediate to advanced skill in using Power BI, SAS and Congos
- Excellent communication and presentation skills
- Excellent clinical and pharmaceutical knowledge

**Education**:
Bachelor's degree in Pharmacy