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Clinical Pharmacist

Umpqua Health
Full-time
Remote
United States
$111,000 - $167,000 USD yearly
Are you looking to join a team of like-minded professionals who are passionate about serving Douglas County OHP members, engaging with the community, and delivering outstanding customer service?
At Umpqua Health, we are committed to recruiting top-tier team members who provide exceptional service with professionalism, compassion, and respect for the unique needs of every individual we serve.
If you thrive in a fast-paced, dynamic healthcare environment and are ready to make a meaningful impact, you may be the team member we’re looking for.
We seek individuals who:
  • Possess genuine compassion and empathy for our members
  • Can adapt to ever-evolving healthcare regulations and requirements
  • Are motivated by challenges and dedicated to delivering superior customer service
Join us in serving over 40,000 Douglas County residents as we administer Medicaid benefits and work together to improve health outcomes in our community.

Umpqua Health is a mission-driven, community-focused healthcare organization proudly serving Douglas County, Oregon. Locally owned by CHI Mercy Health and the Douglas County Individual Practice Association (DCIPA), we are deeply rooted in the region and dedicated to improving the health and well-being of our friends, families, and neighbors.

Umpqua Health is the parent company of Umpqua Health Alliance, one of 16 Oregon coordinated care organizations serving the Oregon Health Plan. The Roseburg-based company and its subsidiaries are focused on expanding access, improving care, and reducing unnecessary costs across the clinical space for more than 40,000 Douglas County residents on the Oregon Health Plan and close to 10,000 more individuals with Medicare, private insurance or Exchange coverage.

Job Description
JOB TITLEClinical PharmacistREPORTS TODirector of Clinical Pharmacy Services
STATUSFT, ExemptWAGE RANGE22 (2024)
DEPARTMENTPharmacyWORK LOCATIONRemote (occasional travel as required)
 
POSITION PURPOSE
Umpqua Health is seeking a detail-oriented and collaborative Pharmacist to join our Clinical Engagement team. In this role, you will apply your clinical expertise to support utilization management, pharmacy benefit oversight, and integrated care coordination. Acting as a liaison between providers, members, pharmacies, and internal teams, you’ll help ensure that pharmacy services are clinically appropriate, cost-effective, and in alignment with UHA, OHP, and state and federal guidelines. This position plays a critical role in driving quality improvement and population health outcomes while upholding Umpqua Health’s mission and values. 
 
ESSENTIAL JOB RESPONSIBILITIES
  • Review and determine prior authorization requests and appeals for medications covered under the Oregon Health Plan (OHP), ensuring compliance with medical necessity, state rules, and clinical guidelines. 
  • Stay current on Oregon Administrative Rules (OAR) and the Health Evidence Review Commission (HERC) Prioritized List to support coverage determinations and care review processes. 
  • Analyze claims data and utilization trends to evaluate appropriateness, effectiveness, and cost of medication services across the care continuum. 
  • Participate in Interdisciplinary Care Team (ICT) meetings to support coordinated member care planning and medical management initiatives. 
  • Support formulary management activities, including configuration change requests and collaboration with the pharmacy benefit manager (PBM). 
  • Prepare clinical documents such as drug monographs and evidence reviews for UHA’s Pharmacy & Therapeutics (P&T) Committee. 
  • Assist in developing, applying, and updating clinical criteria for managing pharmacy and medical benefit drug coverage. 
  • Execute daily responsibilities within the Medication Management program, including medication therapy management (MTM), medication reconciliation, targeted follow-up, and patient outreach. 
  • Provide medication counseling and education to members under the supervision of a licensed pharmacist, ensuring understanding of therapies and adherence. 
  • Assist in coordinating medication-related services across departments, resolving barriers and streamlining access for members and providers. 
  • Support member education related to pharmacy benefits, rights, and responsibilities; collaborate with grievance and appeals teams as needed. 
  • Respond to pharmacy inquiries to prevent care delays, ensure timely medication access, and maintain strong community partnerships. 
  • Contribute to policy and procedure development, workflow optimization, and system-wide quality improvement initiatives. 
  • Perform other duties as assigned to support Umpqua Health’s Vision, Mission, and Organizational Values. 
 
CHALLENGES
  • Working with a variety of personalities, maintaining a consistent and fair communication style.
  • Satisfying the needs of a fast paced and challenging company.
 
QUALIFICATIONS
Minimum Qualifications
  • PharmD from an accredited school of pharmacy. 
  • Current and active Oregon Board of Pharmacy license or eligibility for licensure in Oregon. 
  • Minimum of 2 years’ experience in a clinical pharmacy setting; managed care and population health experience strongly preferred. 
  • Proficiency in interpreting claims data, clinical analytics, and reporting. 
  • Strong understanding of Oregon Health Plan, Oregon Administrative Rules (OAR), and Medicare Part D preferred. 
  • Demonstrated knowledge of quality improvement frameworks and experience supporting related initiatives. 
  • Excellent interpersonal, written, and verbal communication skills. 
  • Proven time management and critical thinking abilities in a fast-paced healthcare environment. 
  • No current suspension, exclusion, or debarment from participation in federal healthcare programs.

Preferred Qualifications
  • Experience considering the impacts of the work on multiple communities, including communities of color, in technical analysis.
  • Experience working on a diverse team with different communication styles.
  • Bi-lingual translation or translation capabilities a plus
 
PHYSICAL DEMANDS & WORK CONDITIONS
  • A typical office environment requires standing, sitting, walking, bending, and lifting up to 25 plus pounds. 
  • Ability to travel and drive to in-person meetings or be on-site as required.
  • May be exposed to patient and environment conditions such as unpleasant sights, smells and contagious diseases (clinic only).
EQUAL EMPLOYMENT OPPORTUNITY
UH is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. UH makes hiring decisions based solely on qualifications, merit, and business needs at the time. For more information, read through our EEO Policy.
JOB DESCRIPTION ACKNOWLEDGEMENT
I have reviewed the attached job description as outlined above and understand that I am responsible for all duties as outlined and other tasks as may be assigned. I understand that if I need accommodation to perform the essential functions of my job that I must contact my supervisor or Human Resources as soon as possible to begin an interactive process.
Note: This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.
 
EMPLOYEE SIGNATUREDATE

 






 

About Umpqua Health

At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Umpqua Health serves Douglas County, Oregon, where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high-quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together. Join us in making a difference at Umpqua Health.

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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