Clinical Pharmacist

Are you looking to join a team of like-minded professionals who are passionate about serving Douglas County OHP members, engaging with the community, and delivering outstanding customer service?

At Umpqua Health, we are committed to recruiting top-tier team members who provide exceptional service with professionalism, compassion, and respect for the unique needs of every individual we serve.

If you thrive in a fast-paced, dynamic healthcare environment and are ready to make a meaningful impact, you may be the team member we’re looking for.

We seek individuals who :

• Possess genuine compassion and empathy for our members Can adapt to ever-evolving healthcare regulations and requirements Are motivated by challenges and dedicated to delivering superior customer service Join us in serving over 40,000 Douglas County residents as we administer Medicaid benefits and work together to improve health outcomes in our community.
• Umpqua Health is a mission-driven, community-focused healthcare organization proudly serving Douglas County, Oregon.
• Locally owned by  CHI Mercy Health  and the  Douglas County Individual Practice Association  (DCIPA), we are deeply rooted in the region and dedicated to improving the health and well-being of our friends, families, and neighbors.
• Umpqua Health is the parent company of Umpqua Health Alliance, one of 16 Oregon coordinated care organizations serving the Oregon Health Plan.
• The Roseburg-based company and its subsidiaries are focused on expanding access, improving care, and reducing unnecessary costs across the clinical space for more than 40,000 Douglas County residents on the Oregon Health Plan and close to 10,000 more individuals with Medicare, private insurance or Exchange coverage.
• Job Description JOB TITLE Clinical Pharmacist REPORTS TO Director of Clinical Pharmacy Services STATUS FT, Exempt WAGE RANGE 22 (2024) DEPARTMENT Pharmacy WORK LOCATION Oregon   POSITION PURPOSE Umpqua Health is seeking a detail-oriented and collaborative Pharmacist to join our Clinical Engagement team.

In this role, you will apply your clinical expertise to support utilization management, pharmacy benefit oversight, and integrated care coordination.

This position plays a critical role in driving quality improvement and population health outcomes while upholding Umpqua Health’s mission and values.    ESSENTIAL JOB RESPONSIBILITIES Review and determine prior authorization requests and appeals for medications covered under the Oregon Health Plan (OHP), ensuring compliance with medical necessity, state rules, and clinical guidelines.  Stay current on Oregon Administrative Rules (OAR) and the Health Evidence Review Commission (HERC) Prioritized List to support coverage determinations and care review processes.  Analyze claims data and utilization trends to evaluate appropriateness, effectiveness, and cost of medication services across the care continuum.  Participate in Interdisciplinary Care Team (ICT) meetings to support coordinated member care planning and medical management initiatives.  Support formulary management activities, including configuration change requests and collaboration with the pharmacy benefit manager (PBM).  Prepare clinical documents such as drug monographs and evidence reviews for UHA’s Pharmacy & Therapeutics (P&T) Committee.  Assist in developing, applying, and updating clinical criteria for managing pharmacy and medical benefit drug coverage.  Execute daily responsibilities within the Medication Management program, including medication therapy management (MTM), medication reconciliation, targeted follow-up, and patient outreach.  Provide medication counseling and education to members under the supervision of a licensed pharmacist, ensuring understanding of therapies and adherence.  Assist in coordinating medication-related services across departments, resolving barriers and streamlining access for members and providers.  Support member education related to pharmacy benefits, rights, and responsibilities; collaborate with grievance and appeals teams as needed.  Respond to pharmacy inquiries to prevent care delays, ensure timely medication access, and maintain strong community partnerships.  Contribute to policy and procedure development, workflow optimization, and system-wide quality improvement initiatives.  Perform other duties as assigned to support Umpqua Health’s Vision, Mission, and Organizational Values.    CHALLENGES Working with a variety of personalities, maintaining a consistent and fair communication style.

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