Ambulatory Care Clinical Coordinator / Pharmacist

Ambulatory Care Clinical Coordinator / Pharmacist

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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 include supporting the patient-centered medical home, incorporating principles of population-based medicine, expanding and coordinating the expansion of pharmaceutical care services to patients across the health-system through primary care clinics, community pharmacies, or other designated environments. Care Coordination: This position is responsible for coordinating effective use of the pharmacy benefit by delivering clinical and educational interventions designed to improve pharmaceutical care. Network Liaison: This position is responsible for aligning the clinical pharmacist network with CareOregon strategic goals and aiding the advancement of the practice of clinical pharmacy.

Estimated Hiring Range

$154,980.00 - $189,420.00

Bonus Target

• Bonus - SIP Target, 5% Annual
• Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.

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Essential 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.
• Experience and/or Education
• Required
• 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
• Knowledge, Skills and Abilities Required
• Knowledge

Knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization

• Must have comprehensive, clinical pharmaceutical knowledge base
• Skills and Abilities

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
• Must be highly motivated and have the ability 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 Community Facilities/Security Outdoor Exposure
• Member/Patient Facing: No Telephonic In Person
• 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

We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e. g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.

We are an equal opportunity employer

CareOregon is 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.