Clinical Pharmacist

Position Summary :

The Clinical Pharmacist will conduct research and maintain or enhance clinical pharmacy programs such as drug utilization review, health outcomes, disease state management, care management, and other specialty programs.

The Clinical Pharmacist will work to drive pharmacy initiatives and clinical programs for all lines of business. The clinical pharmacist will research, develop, and update drug utilization management strategies and work to promote clinically appropriate prescribing practices which adhere to applicable formulary, regulatory guidelines, and national clinical practice guidelines.

The Clinical Pharmacist will interact frequently and independently with Plan members, prescribers, pharmacies, collaborative care team members, and with the PBMs.

Essential Duties and Responsibilities :

• Develop and implement medication therapy management (MTM) telephonic
• pharmacotherapy consultations to patients and / or prescribers promoting high quality,
• evidence-based, cost-effective pharmaceutical care
• Complete a comprehensive medication review of prescription and non-prescription medications with emphasis on patient assessment and counseling, safe and effective use of medications, identification of potential drug interactions, and other related activities
• Complete pharmacotherapy assessment of patients' claims, past medical history, and disease states
• Assess patients for medication adherence barriers and develop a plan to maximize patients' medication success through improving or maintaining adherence to medications
• Develop a plan of care that details actions of the patient and / or prescriber based on the Pharmacotherapy assessment
• Deliver high quality evidence-based therapeutic recommendations to providers
• Medication reconciliation when appropriate
• Generate and analyze claims and utilization reports to track general trends in drug
• utilization and to identify potential targeted utilization management activities.
• Participate in medication review, disease state management, and other clinical quality
• improvement programs and interdisciplinary care teams.
• Support pharmacy / drug utilization management though the collection of information and documents processed through pharmacy benefit managers / or relevant intake entities to support timely review and coverage determination based on prior authorization criteria, formulary criteria, and formulary exception criteria and regulatory timeframes.
• Maintain a high level of clinical knowledge of chronic disease states and changes in pharmacy practice in pediatric, adult, and geriatric patient populations to serve as an authoritative information source on drugs and their utilization in therapy
• Proactively develop and maintain contacts and relationships with providers for successful interaction and intervention activities.
• Adhere to regulatory compliance and quality guidelines
• Update Pharmacy policies and develops new policies and procedures when needed.
• Work with the Pharmacy Director to recommend, develop and implement target drug utilization intervention programs and other DUR / DUE activities.
• Resolve complaints, actively participate in the grievances and appeals process.
• Participate in reporting, evaluating, and auditing as required
• General duties will include development of and participation in clinical programs, including medication therapy management, development of drug utilization criteria, review of prior authorizations and appeals, when necessary, interface with Plan members and prescribers to discuss drug therapy and will perform other projects and reports as assigned.

This job description in no way states or implies that these are the only duties performed by the employee occupying this position.

Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Work Schedule :

As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule.

Staff are able to work from home 3 days a week and will report to the office 2 days a week. The company reserves the right to change the work schedules based on the company needs.

Skills and Abilities :

• Ability to participate in or develop a quality improvement program.
• Ability and willingness to train department trainees, interns, and residents.
• Excellent oral and written communication skills.
• Ability to work flexible work hours.
• Ability to travel to attend meetings as needed.
• Manage multiple, concurrent projects for completion in a thorough and timely fashion.
• Analyze data and formulate conclusions and recommendations.
• Educate and persuade groups and individuals to alter behavior in accordance with program goals and objectives.

Work Schedule :

As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule.

Staff are able to work from home 3 days a week and will report to the office 2 days a week. The company reserves the right to change the work schedules based on the company needs.

Physical Demands :

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear.

The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl.

The employee may occasionally lift and / or move up to 15 pounds.

Work Environment :

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job.

The environment includes work inside / outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique.

We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.

Qualifications

• Must have a current, valid, unrestricted Florida State Pharmacy License and Pharm D.
• Must have current knowledge and expertise in clinical pharmacology and disease states.
• ASHP-accredited residency in Pharmacy Practice or equivalent background / experience preferred.
• Certified in Medication Therapy Management preferred.
• Current clinical pharmacotherapeutics and disease state management.
• At least 3-5 years’ experience in clinical pharmacy practice including performing drug use evaluations, with at least 3 years’ experience in managed care setting preferred.
• Demonstrates knowledge of the principles of MTM.
• Knowledge of regulatory agencies.
• Knowledge of computer software for word processing, spreadsheets, and graphics (Microsoft Office or similar).
3 hours ago