Ambulatory Care Clinical Coordinator / Pharmacist

About the role

The Ambulatory Care Clinical Coordinator (pharmacist) is responsible for providing oversight of an assigned area (i.e., Care Coordination or Network Liaison). The pharmacist needs to demonstrate consistent application of knowledge and skills related to pharmacy benefits, quality measures, and other initiatives in order to communicate, partner, and deliver appropriate, safe, efficient, and cost-effective patient care as part of a multidisciplinary team.

Responsibilities

• Develop and conduct quality improvement programs related to the pharmacy program.
• Develop and implement clinical educational programs to improve drug utilization and quality.
• Develop and conduct educational initiatives to improve prescribing patterns for quality and/or cost opportunities to support sustainable cost trends with the highest quality.
• Develop and critically evaluate pharmacy claim data analysis/reports in support of specific projects or program objectives.
• Develop and conduct retrospective drug use reviews.
• Leading the design, development, and implementation of quality improvement initiatives related to the pharmacy program will be an important aspect of this position.
• Review medication prior authorization requests and appeals as assigned.
• Review and refine policies and procedures regarding Pharmacy Department functions including medication therapy management, DUR programs, medication prior authorization, and others as applicable.
• Use an evidence-based process to perform new drug reviews, and to develop formulary recommendations and drug use criteria for the Pharmacy & Therapeutics Committee and other pharmacy program activities as assigned.
• Assess, review and respond to federal and state regulatory requirements/audits of the pharmacy benefit.
• Consult with clinicians and pharmacists to resolve pharmacy benefit issues.
• Precept pharmacy students and residents.

Care Coordination

• Critically evaluate drug therapy regimens for patients enrolled in the care coordination program and assist with developing treatment plans.
• Provide medication therapy management (MTM) services.
• Utilize technology platforms to document and to meet MTM objectives.
• Monitor MTM objectives and high-risk population outcomes in partnership with the pharmacy benefit coordinator to provide oversight.
• Perform medication reviews and other tasks as assigned to meet plan quality metrics.

Requirements

• Minimum Graduate of an accredited pharmacy program
• Current (or eligible) unrestricted licensure as a pharmacist in the state of Oregon
• Advanced pharmacy training (PharmD, residency, fellowship, board certification or master’s degree in related discipline)
• Practical experience with minimum 2 years as a clinical pharmacist in pharmaceutical care management in an ambulatory care or other clinical setting (which can include residency experience)

Preferred

• Previous experience in managed care and project management
• PGY1 residency training

Skills and Abilities

• Knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization
• Comprehensive, clinical pharmaceutical knowledge base
• 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
• Highly motivated and able to work independently
• Excellent organizational, project management, and time-management skills
• Excellent written and verbal communication skills
• Excellent customer service skills
• Ability to work with diverse groups
• Ability to manage multiple tasks
• Ability to negotiate, problem-solve, and consensus-build
• Basic word processing, spreadsheet, and database skills
• Propose and implement process improvements
• Meet deadlines for completion of workload
• Maintain agreed upon work schedule
• Demonstrate cooperation and teamwork
• Provide cross-training on specific job responsibilities
• Meet identified business goals that contribute to departmental goals
• Follow established departmental policies and procedures
• Perform other duties and projects as assigned
• 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 perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day
• Ability to lift, carry, push, pull and/or pinch small objects for at least 1-3 hours/day

Working Conditions

• Work Environment(s): Indoor/Office
• Member/Patient Facing: No
• Hazards: May include, but not limited to, physical and ergonomic hazards
• Equipment: General office equipment
• 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
• Work Location: Work from home

Benefits

• Competitive pay
• Bonus opportunity
• Comprehensive benefits package
• Medical, dental, vision, life, AD&D, and disability insurance
• Health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits
• Strong retirement plan with employer contributions
• Paid State Sick Time
• Wellness and employee assistance program benefits
• Other perks

Equal Opportunity Employer

We are an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.