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Clinical Program Advisor/Clinical Pharmacist (Managed Care)/NON-REMOTE

ChenMed

Clinical Program Advisor/Clinical Pharmacist (Managed Care)/NON-REMOTE

Miami, FL
Full Time
Paid
  • Responsibilities

    Job Description

    WE’RE UNIQUE.  YOU SHOULD BE, TOO.

    We’re changing lives every day.  For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts?  Do you inspire others with your kindness and joy?

    We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

    Facilitates the engagement in a collaborative healthcare model that strives to improve patient health outcomes. Proactively communicate with patients and providers to effectively optimize prescription drug regimens and therapeutic outcomes to reduce healthcare costs while improving patient experience. This includes providing information related to medication counseling, discussion of therapy alternatives, standards of care, and preventative care measures. Work collaboratively in the implementation of clinical pharmacy programs and service aids. Ensures clinical compliance with law and regulatory bodies. Pursues continual professional development to identify best practices and improve patient care.ESSENTIAL JOB DUTIES/ RESPONSIBILITIES:

    • Responsible for the day-to-day management of clinical pharmacy programs including but not limited to medication adherence, medication therapy management (MTM), utilization, polypharmacy and high-risk medication monitoring
    • Assists in planning and implementing new and revised clinical programs and services
    • Serves as a formulary, pharmacy benefits, and drug information resource, assisting Clinical, Pharmacy, HEDIS, and other departments as well as allied healthcare providers across the organization
    • Contributes to projects aimed at improving Part D Star ratings and other pharmacy-related quality metrics
    • Monitors drug utilization and assists leadership team in understanding quality and cost control issues related to pharmacy
    • Works with the PBM to manage formulary changes and provide updates to the clinical leaders 
    • Works with leadership on developing annual training sessions for applicable staff regarding the pharmacy benefit changes for the upcoming year
    • Provides medication therapy management services including examination of member medical records, performing a comprehensive medication review and targeted medication reviews, and communicating with members and providers, including outbound calls to members to discuss their medications
    • Reviews members' medication profiles and applies evidence based medicine and national guidelines when creating recommendations to health care providers for optimizing the members' medication regimen
    • Analyzes and reviews medication lists for potential patient safety problems, including drug interactions, suboptimal medication regimens, etc.
    • Assists Director with developing/updating policies and procedures and implementing changes to comply with state and federal regulations
    • Provides clinical medication therapy evaluations and recommendations to members and providers regarding the safe appropriate and cost-effective use of medication
    • Assists the Director of Pharmacy in the advanced pharmacy practice rotations for fourth year pharmacy school students
    • Performs other duties as assigned and modified at manager’s discretion
    • Create, develop, and implement clinical pharmacy programs including but not limited to medication adherence, drug utilization management, polypharmacy and high-risk medication monitoring
    • Provide clinical oversight and support for the concept, design, and program development, implementation, operations, and reporting of pharmacy clinical programs
    • Responsible for ensuring that pharmacy clinical programs are clinically sound and successful in improving health outcomes, the cost of care, patient experience, and provider satisfaction

    We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better.  Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care. 

    ChenMed is changing lives for the people we serve and the people we hire.  With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow.  Join our team who make a difference in people’s lives every single day.

    KNOWLEDGE, SKILLS AND ABILITIES:

    • Strong professional work ethic
    • Self-directed, but also able to work well in a group
    • Ability to work independently, exercising sound judgment, discretion and the initiative to facilitate change
    • Excellent organizational skills, diplomacy, and professionalism
    • Excellent analytical and problem-solving abilities and interpersonal, written, and verbal communication skills
    • Ability to operate a computer and working knowledge of MS Office Suite and database software applications
    • Able to travel nationally up to 20% of the time
    • Fluent in English; bilingual a plus

    EDUCATION AND EXPERIENCE CRITERIA:

    • Must be a Florida licensed and registered pharmacist in good standing
    • Doctor of Pharmacy degree from an accredited college of pharmacy
    • Minimum (2) years of pharmacist experience required
    • Experience in a managed care setting (HMO, MSO, PBM) preferred
    • Managed Care Pharmacy residency training preferred
    • HEDIS Stars experience preferred, but not required
    • Medication Therapy Management certification is a plus
    • Certified to provide immunizations is a plus

    Facilitates the engagement in a collaborative healthcare model that strives to improve patient health outcomes. Proactively communicate with patients and providers to effectively optimize prescription drug regimens and therapeutic outcomes to reduce healthcare costs while improving patient experience. This includes providing information related to medication counseling, discussion of therapy alternatives, standards of care, and preventative care measures. Work collaboratively in the implementation of clinical pharmacy programs and service aids. Ensures clinical compliance with law and regulatory bodies. Pursues continual professional development to identify best practices and improve patient care. By submitting your interest in this job, you agree to receive text notifications with additional steps to complete your job application. You will receive up to 6 messages from the number "63879". Message & data rates may apply. Please refer to our privacy policy for more information.