Value Care Clinical Pharmacist

Description

We're Hiring:
Value Based Care Clinical Pharmacist – Hybrid in State of Colorado

Join Carina Health Network and help us make Colorado communities healthier!

Are you passionate about population health and interested in improving patient experience and outcomes? We support community health organizations across Colorado with technology, data, and resources that help people get the care they need, when and where they need it. If you're looking for a mission-driven organization where your work has a real impact in real communities, Carina could be the right place for you.

At Carina Health Network, we’re transforming community health by helping our members deliver proactive, data-informed, and whole-person care that drives measurable impact. Our work helps people with chronic conditions like diabetes and high blood pressure stay healthier, ensure older adults get regular check-ups, and identify mental health needs early. We help reduce unnecessary emergency room visits by connecting people with the right care at the right time.

Join us in reimagining the future of health care, where your work truly matters.

The Clinical Pharmacist plays a key role in advancing population health initiatives and optimizing performance across value-based care (VBC) programs. This role will support community health centers (CHCs) and contribute to clinical programming, quality improvement, and risk adjustment initiatives within the Clinically Integrated Network (CIN), Medicare Shared Savings Program, Medicare Advantage, and other VBC contracts.

The Clinical Pharmacist is responsible for leading medication management for patients with chronic conditions, with a primary focus on diabetes and hypertension, including oversight of remote patient monitoring (RPM) for these conditions. This role provides clinical oversight and strategic direction for medication optimization, adherence interventions, and pharmacy technician workflows. The Clinical Pharmacist also plays a key role in supporting Medicare Advantage (MA) contracts, including performance on Stars and HEDIS measures, through evidence-based medication management and quality improvement initiatives.

Chronic Disease Management:

• Provide clinical oversight for medication management for patients with diabetes and hypertension.
• Optimize medication regimens based on clinical guidelines, patient-specific factors, and barriers to adherence.
• Conduct comprehensive medication reviews, including identification of polypharmacy risks, drug interactions, and therapeutic duplication.
• Support clinical teams in medication titration protocols under collaborative practice agreements, where applicable.
• Consult with providers on complex medication regimens and serve as a clinical resource on chronic disease pharmacotherapy.

Remote Patient Monitoring:

• Actively manage patients enrolled in RPM by reviewing blood pressure and glucose readings, conducting patient outreach to address abnormal values, providing education and coaching, and supporting medication changes as needed.
• Establish medication adjustment workflows aligned with RPM data and escalation protocols.
• Review RPM dashboards and trends to proactively identify patients needing intervention.
• Collaborate with care teams and providers to act on RPM alerts and abnormal readings.
• Support documentation and billing workflows related to RPM services.

Medication Adherence and Pharmacy Technician

Collaboration:

• Oversee pharmacy technician workflows supporting medication adherence calls, refill alignment, outreach, and education.
• Design, implement, and refine adherence strategies (e.g., refill sync, cost mitigation, side-effect counseling).
• Prioritize patients for adherence support using pharmacy claims data, risk stratification lists, and payer adherence thresholds.
• Ensure adherence programs are aligned with Stars, HEDIS, and quality contract expectations.

Medicare Advantage, Stars & HEDIS Quality Program Support:

• Understand medication-related quality measures (i.e., Statin Use in Persons with Diabetes, Diabetes Control, Controlling Blood Pressure).
• Identify performance gaps and partner with clinical and network teams to design…