Providence Clinical Pharmacy Specialist - Managed Care in Beaverton, Oregon
Providence St. Joseph Health is calling a Clinical Pharmacy Specialist - Managed Care to our location in Beaverton, OR.
We are seeking a Clinical Pharmacy Specialist - Managed Care who will be responsible for the effective provision of clinical pharmacy services to members of Providence Health Plan (PHP). The CPS will collaborate with medical directors, nurse case managers, and network physicians and other providers to provide coordinated, high quality and evidenced-based, cost-effective care to PHP members. The responsibilities of the CPS predominantly fall into the following areas: (1) direct patient care through Medication Therapy Management (MTM) program, (2) population-based disease management, (3) specialty pharmaceutical acquisition and care coordination, (4) drug utilization review and program development, (5) clinical policy development and application, including Pharmacy and Therapeutics (P&T) Committee participation. The CPS is skilled at reviewing pharmacy and medical claims; interacting with, assessing and providing education to members and caregivers; developing medication-related problem lists; and implementing medication action plans including interventions with health care providers. Education and consultation with physicians, pharmacists, nurses, and other members of the health care team, both internally and externally, will be required. Drug utilization work and medical policy activities will include developing and applying drug medical policies to influence safe, quality, and cost-effective use of prescription pharmaceuticals.
In this position you will have the following responsibilities:
Coordinates and provides comprehensive clinical pharmacy services to patients receiving medication therapy management, including:
Assessment and identification of medication-related problems based upon evaluation and interpretation of patient history, medical condition, surgical history, drug therapies, and objective physical and biochemical data.
Development and execution of a patient-specific medication-related action plan designed to improve safety and quality which includes recommendations regarding the identified medication-related problems including (but not limited to) drug interactions, duplicate drugs, drugs to avoid in special populations, inappropriate drug doses, adherence and persistence gaps, undertreatment of conditions, adverse effects, cost barriers, and assuring that clinical therapeutic monitoring and endpoints are established.
Collaboration with member's providers regarding results and recommendations from clinical pharmacy services, provision of education and evidence-based support for recommendations, and ensuring follow-through with member. Track ongoing outcomes of clinical interventions and perform routine follow-up to detect changes and new problems as they arise since previous interventions.
Effectively communicate verbally and/or in writing regular communication of clinical pharmacy functions to multidisciplinary team members and other health care professionals including physicians, pharmacists, nurses and others who may be participating in a patient's care.
Participates in educational activities and programs for health plan professional staff using effective and appropriate teaching methods.
Performs drug utilization management functions and initiatives including medical drug policy generation, review, and application including prior-authorization, general DUR, and population and group level initiatives and educational programs to improve safety and quality in the provision of drug therapy.
Serves as a resource person to physicians and nurses requesting clinical pharmacy services support.
Participates in meetings of the MTM team, pharmacy department, QMM department, PHP all-staff, and other groups and committees as assigned.
Coordinates ongoing quality assurance evaluations of clinical pharmacy services activities and implements necessary action as appropriate.
Skilled in Microsoft applications, with ability to analyze and manipulate complex datasets
Participates in educational activities including, but not limited to, patient education, provider and staff presentations, newsletters and evidence-based literate reviews as assigned.
Required qualifications for this position include:
PharmD graduate from an accredited College or School of Pharmacy or Bachelors or MS Degree in pharmacy considered with 5 or more years of managed care experience with documented responsibility for evidence and clinical case review and direct consultation of medication information with physicians and/or patients.
Coursework/Training: PGY-1 Residency training with 1 year of experience within relevant practice setting or PGY-1 Managed Care Residency with PHP OR 3 years’ experience as a clinical pharmacist in managed care.
Experience in writing, including research protocols, medical papers for publication, and educational pieces for patients and healthcare providers.
Experience reviewing medication evidence and clinical policy development.
Experience working in programs and services that support population health management.
Current registration and licensure by the Oregon State Board of Pharmacy or the ability to obtain licensure prior to employment.
Preferred qualifications for this position include:
Coursework/Training: Completion of specialty/PGY-2 Residency.
Experience and expertise working with a pharmacy claims processing platform.
Board Certification: Board of Pharmaceutical Specialties certification.
About Providence in Oregon.
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs.
At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Pharmacists
Req ID: 285560