Description:
Must have specific state license. (AL)
The Clinical Engagement Services Center team provides a variety of clinical services, such as: Adherence, Diabetes, Fraud Waste & Abuse, Medication Therapy Management, Retrospective Drug Utilization, and STARS adherence.
The team comprises of clinical pharmacists, certified pharmacy technicians, and customer service representatives that complete various functions to successfully meet the operational requirements of each clinical service. The work hours required will require flexibility to work rotating shifts between the hours of 8:00am and 8:00pm CST, Monday through Friday.
The Clinical Pharmacist will report into the Operations Team Supervisor and Manager. This role is primarily responsible for performing telephonic consultations with members to complete comprehensive medication reviews and improve disease state management. In addition, the clinical pharmacist will document the care delivered and communicates essential information to the member’s primary care providers. In addition, this role may require the pharmacist to interact with members on site as needed and complete the comprehensive medication review in person.
Responsibilities
• Engage members telephonically and schedule pharmacist consultation appointments with members that participate in any of the clinical programs operationally supported by the Clinical Engagement Services Center.
• Utilize prescription claims data to generate clinical recommendations according to Medication Therapy Management and Retrospective Drug Utilization Review program protocols providing clinical recommendations pertaining to, but not limited to, gaps in care, high risk medications, compliance and adherence, drug interactions, therapeutic substitution, and generic substitution
• Assess medication regimen for unnecessary medications, ineffective medications, inappropriate doses, and adverse drug reactions.
• Provide patient education on medication regimen and disease states.
• Accurately document patient care notes and recommendations in an efficient, professional, concise and clear manner.
• Keep current with new and emerging clinical trends
• Active participation in departmental meetings to improve clinical programs and enhance processes
• Follow all policies and procedures related to job
• Meet productivity and performance expectations set forth by management.
• Support Clinical Service Engagement team as needed for special projects
• Other duties as assigned by Operations Manager
Required Qualifications
• Bachelor’s Degree in Pharmacy or PharmD
• Current and unrestricted Pharmacist license in the state of Louisiana.
• Strong knowledge of disease state management guidelines and the 5 Core Elements of MTM Services (1) Medication Therapy Review – Comprehensive and Targeted, 2) Personal Medication List (PML), 3) Medication-Related Action Plan (MAP), 4) Interventions and Referrals, and 5) Documentation of Services and Follow-up)
• Experience working remotely/independently within a cross functional team environment, self-directed with excellent organizational skills.
• Ability to navigate approved MTM platforms and multi-task using multiple databases/platforms, and applications. Competent use of computers/technology.
• The work hours required will require flexibility to work rotating shifts between the hours of 8:00am and 8:00pm CST, Monday through Friday. Extended hours and occasional weekends may be required as needed.
Preferred Qualifications
• PharmD
• Bilingual (fluent in medical terminology) in Cantonese, Korean, Mandarin, Russian, Spanish, or Vietnamese
• 2+ years Pharmacy work experience in retail / community pharmacy and / or PBM, but will consider new graduate experientials
• Additional Pharmacist License in good standing in Alabama, Idaho, Kentucky, Maryland, Minnesota, Oregon, Tennessee, or Vermont
• Prior call center experience
• ACPE MTM Specialist
• Certified Geriatric Specialist
• Board Certified Pharmacist