Certified Managed Care Pharmacist (CMCP)

CMCP (MCP-001) Exam Objectives

This exam certifies that the candidate has the knowledge and skills to manage a pharmacy benefit and improve medication-related outcomes on a population level.

Domain 1: Formulary and Utilization Management (40%)

• Formulary Management: Manage the formulary review process, including monograph development and P&T committee presentations.
• Utilization Management (UM): Design, implement, and oversee UM programs, including prior authorization, step therapy, and quantity limits.
• Pharmacy and Therapeutics (P&T) Committee: Describe the function, governance, and management of a P&T committee.

Domain 2: Payer Contracting and Health Economics (25%)

• Pharmacoeconomics: Apply principles of pharmacoeconomic analysis (e.g., CEA, BIM) to formulary decisions.
• Rebate Contracting: Understand the principles of negotiating and managing pharmaceutical rebate contracts.
• Network Management: Describe the process of creating and managing a network of participating pharmacies.

Domain 3: Clinical Program Development and Quality (25%)

• Quality Measurement: Describe the major medication-related quality measures (e.g., HEDIS, Medicare Star Ratings) and their impact on a health plan.
• Clinical Program Design: Develop targeted clinical programs (e.g., MTM, adherence initiatives) to improve quality scores and patient outcomes.
• Data Analysis: Analyze pharmacy claims data to identify trends in utilization and opportunities for clinical intervention.

Domain 4: Pharmacy Benefit Design and Operations (10%)

• Benefit Structure: Differentiate between different pharmacy benefit designs (e.g., co-pays, coinsurance, tiers, deductibles).
• Specialty Pharmacy: Describe the management of high-cost specialty drugs within a pharmacy benefit.
• Medicare Part D: Understand the basic structure and requirements of the Medicare Part D benefit.

Eligibility Requirements

To be eligible to sit for a CPS certification exam, candidates must meet the criteria outlined in one of the two pathways below.

Pathway 1: For U.S. Licensed Pharmacists

This pathway is for pharmacists licensed to practice within the United States, regardless of country of graduation.

• Hold an active and unrestricted pharmacist license in any state or territory of the United States.
• Meet educational requirements by being a graduate of an ACPE-accredited school of pharmacy or holding a Foreign Pharmacy Graduate Examination Committee® (FPGEC) Certificate.
• Fulfill the specialty experience requirement as outlined below.

Pathway 2: For International Pharmacists (Non-U.S. Licensed)

This pathway is for pharmacists who practice outside of the United States.

• Hold an active and unrestricted license to practice pharmacy in their country of practice. A certified English translation of the license must be provided if the original is not in English.
• Hold a professional degree in pharmacy equivalent to a U.S. pharmacy degree, such as a Bachelor’s degree (BPharm), Master’s degree in Pharmacy Practice (MPharm), or Doctor of Pharmacy degree (PharmD).
• Fulfill the specialty experience requirement as outlined below.

Specialty Experience Requirement (for all pathways)

To ensure candidates have foundational knowledge in the specialty, one of the following criteria must be met:

• Standard Pathway:
  Completion of at least one year of professional experience in a practice setting directly related to the certification area.
• Certificate Pathway:
  The one-year specialty experience requirement is waived for candidates who hold an active certificate of completion from a nationally recognized provider in a related subject matter. This includes, but is not limited to, the completion of a relevant PGY residency, fellowship, certificate/training program, or a relevant graduate degree (e.g., a Master's degree in the specialty field). Recognized providers of certificate programs include, but are not limited to:
  • American Society of Health-System Pharmacists (ASHP)
  • American Pharmacists Association (APhA)
  • American College of Clinical Pharmacy (ACCP)
  • American Society of Consultant Pharmacists (ASCP)

Career Path for CMCP Professionals

The CMCP certification is for pharmacists who are leaders in managing pharmacy benefits and population health. This credential is a key differentiator for roles within health plans, Pharmacy Benefit Managers (PBMs), and large health systems with their own insurance products.

Target Candidates

• Pharmacists working for health plans, PBMs, or specialty pharmacies.
• Health-system pharmacists involved in formulary management and utilization review.
• Pharmacists interested in a career in the pharmaceutical industry, particularly in market access roles.
• Consultants specializing in pharmacy benefit design.

Primary Job Roles:

• Managed Care Clinical Pharmacist
• Formulary Manager
• Director of Pharmacy (Health Plan)
• Clinical Program Manager
• Pharmacoeconomist / HEOR Professional

Career Advancement:

A CMCP is on a trajectory for senior leadership in the managed care industry. They can advance to become a Vice President of Pharmacy Services, a Chief Pharmacy Officer for a health plan, or a senior leader in a PBM responsible for clinical strategy and formulary development.

Study Resources

Prepare for your CMCP exam with resources designed to master the principles of population-based pharmacy practice.