Job Information
CareOregon Senior Clinical Pharmacist in Portland, Oregon
Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.
Job Title
Senior Clinical Pharmacist
Exemption Status
Exempt
Department
Pharmacy
Manager Title
Director of Pharmacy – Clinical Services
Direct Reports
n/a
Requisition #
24202
Pay and Benefits
Estimated hiring range $149,090 - $180,400 / year, 5% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits
Posting Notes
This is a remote role, but you must reside in one of the listed 9 states.
We are looking to fill the CCO- specific LOB position.
We are looking for a motivated individual who can work independently, thrives in a team-based environment, can be creative and innovative, not afraid to speak up but also listen to other’s opinions, open to other’s points of view, and thinks about equity, diversity, and inclusion when framing thoughts and ideas.
Job Summary
The Senior Pharmacy Clinical Coordinator is responsible for coordinating with staff and providing pharmacy oversight of a line-of-business (LOB) (i.e., Coordinated Care Organization (CCO)) or the pharmacy network (i.e., clinical and community pharmacists). Responsibilities include developing and delivering clinical and educational interventions designed to improve pharmaceutical use and improve prescribing patterns; creating and conducting quality improvement programs related to medication use and other pharmacy program activities as assigned.
Essential Responsibilities
Prepare drug utilization reports and analyses for the Pharmacy & Therapeutics Committee and/or assigned CCO.
Use an evidence-based process to develop formulary recommendations and drug use criteria for the Pharmacy & Therapeutics Committee.
Develop and conduct retrospective drug use reviews.
Develop and implement clinical educational programs to improve drug utilization and quality.
Develop and conduct educational initiatives to improve prescribing patterns.
Develop quality improvement programs and coordinate or conduct activities to improve Medicare or CCO quality metrics.
Develop materials to communicate pharmacy benefit or other information to members, clinicians, and pharmacists.
Position assigned to - CCO – specific LOB
Establish and foster professional relationships and partnerships with local pharmacists, primary care clinic staff, and hospital staff when appropriate to collaborate, provide technical assistance, and support pharmacy programs as well as improve Medicare/CCO quality metrics performance.
Develop and disseminate best practices on high quality clinical care and safe and appropriate medication use.
Communicate formulary changes and medication use initiatives to responsible CCO network partners.
Partner with CareOregon pharmacy benefit leads on areas of opportunity to reduce medication costs and inappropriate utilization.
Implement specific CCO initiatives to meet regulatory requirements, such as opioid reviews.
Critically evaluate drug therapy regimens for patients enrolled in the case management program and assist with developing treatment plans as assigned.
Analyze CCO clinical claims data to identify prescribing trends and develop interventions to support quality and/or process improvement.
Collaborate with diverse multi-disciplinary teams within and outside the organization; grow and leverage community partnerships.
Provide medication therapy management services as assigned.
Represent the health plan in applicable activities including medical and other professional organizations.
Participate in activities that enhance CCO’s image within the community.
Position assigned to – Pharmacy Network
Communicate formulary changes, cost savings initiatives, and strategic goals to network pharmacists by functioning as the main CareOregon point of contact.
Plan and facilitate the pharmacist collaborative meeting.
Review and approve network pharmacist credentialing and maintain up-to-date list of credentialed pharmacists.
Regularly review and recommend CPT codes for clinical and community pharmacist reimbursement.
Evaluate clinical and community pharmacy sites for clinical pharmacy services and provide technical assistance and expertise.
Monitor and report on billing metrics, quality improvement, and alignment.
Maintain the clinical pharmacist reimbursement manual.
Develop processes to refer members to the pharmacy network based on clinical or quality initiatives for both Medicaid and Medicare.
Coordinate with the contracting department on clinic pharmacist contract addendums.
Monitor Oregon Board of Pharmacy prescribing formulary committee approvals.
Organizational Responsibilities
Perform work in alignment with the organization’s mission, vision and values.
Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
Strive to meet annual business goals in support of the organization’s strategic goals.
Adhere to the organization’s policies, procedures and other relevant compliance needs.
Perform other duties as needed.
Experience and/or Education
Required
Graduate from an accredited College of Pharmacy
Advanced degree in pharmacy practice (Pharm.D, M.S., residency, fellowship, board certification or Ph. D) OR a Bachelor of Pharmacy degree and minimum 5 years’ experience of pharmacy practice
A current unrestricted state of Oregon Pharmacy license
Minimum two years practical experience as a clinical pharmacist in ambulatory care or other clinical setting
Preferred
Managed care experience
Knowledge, Skills and Abilities Required
Knowledge
Knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization
Comprehensive, clinical pharmaceutical knowledge base
Skills and Abilities
Ability to critically evaluate clinical pharmaceutical and medical literature and apply principles of evidence-based medicine
Ability to design and review pharmacy claims analysis/reports according to specific project requirements
Ability to guide and mentor staff
Must be highly motivated and have the ability to work independently
Excellent organizational, project management, and time-management skills
Excellent written and verbal communication skills
Ability to manage multiple tasks
Ability to negotiate, problem-solve, and consensus-build
Proficient word processing, spreadsheet, and database skills
Ability to occasionally work on weekends or holidays
Ability to work effectively with diverse individuals and groups
Ability to learn, focus, understand, and evaluate information and determine appropriate actions
Ability to accept direction and feedback, as well as tolerate and manage stress
Ability to see, read, and hear for at least 6 hours/day
Ability to speak clearly and perform repetitive finger and wrist movement for at least 3-6 hours/day
Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☐ No ☒ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.Equipment: General office equipment and/or mobile technology
Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.
#Li-Remote
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.
Veterans are strongly encouraged to apply.
We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.
Visa sponsorship is not available at this time.