Clinical Pharmacist 1

Our client, a Health Insurance company, is looking for a Clinical Pharmacist 1 for their Remote location.
 
Responsibilities:
Utilization Management (UM) Focus:

• The clinical pharmacist position is responsible for and participates in a wide range of provider, patient, employer initiatives and programs.
• The pharmacist supports all of our lines of business which include Medicare, Commercial, Exchange (Marketplace) and Medicaid and manage quality, appropriateness, safety and cost for those member populations.

• The MTM Pharmacist will be responsible for reviewing targeted patients' prescription and medical claims history to identify opportunities to improve therapeutic outcomes & reduce the risk of adverse events.
• The primary function will be telephonic consultations with our members to provide education & coaching as well as to identify potential opportunities to improve patient care.
• The position will also require interaction with prescribers to facilitate appropriate changes to medication regimens.

• Quality/Disease management: Serves as a representative of FLRx pharmacy management on specific quality/disease management initiatives.
• Drug Utilization Review:
• As a member of the DUR team , conducts evaluations, and prepares reports and recommendations on plan, member, provider and employer prescribing profiles
• Participates in and may take leadership on specific utilization evaluation projects.

• For Internal Staff/departments: Serves as a key contact and clinical pharmacy consultant on medication issues for all internal staff/departments
• Employer group Support/consultation: Supports Employer Clinical Consultation Team and Sales/Marketing in serving as a clinical pharmacy expert for our employer clients
• Community Providers (prescribers, physicians, pharmacy): Provides comprehensive support both directly to the providers and indirectly to the pharmacy help desk/customer service by assisting them with questions and issues arising from the community (physicians/members/pharmacy personnel)
• Provides guidance, instruction and mentoring of pharmacy and other health care students involved in experiential rotations in the department Drug information services:
• Serves as a participant in the DI program by supporting/covering the provider and/or member) information hotline, answering questions, conducting literature searches and formulating drug information responses and documents
• Serves as a resource to internal and external customers relative to specific therapeutic topics where the clinical pharmacist is considered a content expert
• Assists in the development of clinical information documents intended for a wide range of uses, including committee support, database application, newsletters, TIP sheets, etc

• Perform telephonic Comprehensive Medication Reviews with members enrolled in the MTM program
• Participates in the MTM core team meeting to help maintain and improve the program
• Perform physician outreach for the CMS mandated Opioid DUR initiative
• Work with leadership to develop clinical programs that can assist with improving STAR measures, reduce hospital admissions and improve outcomes
• Develop written documents for members and providers regarding drug therapy strategies such as inappropriate use, over/under utilization, gaps in care, etc.

• Pharmacy Degree and NY State Licensure for a newly graduated clinical pharmacist with internship experience in an organized health care setting or in a practice environment with direct physician interaction, clinical practice, data analysis and/or benefit interpretation process experience
• Must possess strong customer service orientation and the ability to interface effectively with internal and external customers
• Fundamental knowledge of drug information process/references and ability to conduct research
• Strong clinical pharmacy experience including participation in patient management initiatives
• Able to serve as a professional, articulate and knowledgeable liaison to internal and external organizations, to foster positive relationships with our vendor/partners, and to appropriately advocate for the corporation
• Proficient knowledge of Microsoft Word and Excel
• Excellent verbal and written communication skills with experience communicating with patients (our members) and health care professionals
• Knowledge and skill to conduct a thorough drug regimen review. Strong clinical knowledge base, kept current through continuing education and professional affiliations
• Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities
• Able to learn new systems
• Basic knowledge of CMS minimum standards for MTM services is desired.

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities