Pharmacy​/Pharmacist Inpatient

REDUCED Non-Billable Orientation (NBO) Job - 0 Hours NBO vs. Standard 40 NBO

OR, WA, or CA Pharmacist License Required

3+ Years in a Managed Care Environment Required (meaning dealing with Prior Authorizations, Audits, Appeals, ALJ Court hearings, etc)

Rare weekends required a few times per year

REMOTE - M-F Managed Care Pharmacist

The Clinical Pharmacist Specialist (CPS) is 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.

Patient Population Served:
Neonate, Pediatric, Adolescent, Adult, Geriatric

Consequently, the employee must be competent in the interpretation of a patient's self-report or behavior, and this information must be interpreted with an understanding of the cognitive, physical, emotional/psychosocial and chronological maturation process. The treatment of patients should be individualized and should reflect an understanding of the developmental needs and range of treatment needs for each patient.

• 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, under treatment 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…