Pharmacy Clinical Coordinator (Temporary 9 months)

Pharmacy Clinical Coordinator (Temporary 9 months)

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This position is responsible for assisting with the management of the pharmacy benefit and developing and delivering clinical and educational interventions designed to improve pharmaceutical use. Responsibilities include formulary management; assisting with management of specific patients in the multidisciplinary case management/medication therapy management program, P&T, developing and conducting educational initiatives to improve prescribing patterns; develop and conduct quality improvement programs related to the pharmacy program; evaluating medication authorization requests and providing oversight to the medication PA process; and other pharmacy program activities as assigned.
NOTE: This is a temporary position expected to last 9 months.

Estimated Hiring Range:

$151,965.00 - $185,735.00

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

• Prepare drug utilization reports and analyses for the Pharmacy & Therapeutics Committee.
• Use an evidence-based process to perform new drug reviews, and to develop formulary recommendations and drug use criteria for the Pharmacy & Therapeutics Committee.
• Critically evaluate drug therapy regimens for patients enrolled in the case management program and assist with developing treatment plans.
• Provide medication therapy management services.
• Develop and conduct retrospective drug use reviews.
• Review medication prior authorization requests and appeals.
• Develop and implement clinical educational programs to improve drug utilization and quality.
• Review and refine policies and procedures regarding Pharmacy Department functions including medication therapy management, DUR programs, medication prior authorization, and others.
• Develop and conduct quality improvement programs related to the pharmacy program.
• Monitor functions provided by the plans’ Pharmacy Benefit Manager including pharmacy benefit coding, customer service guidelines, prior authorization activities, and other delegated services.
• Develop and critically evaluate pharmacy claim data analysis/reports in support of specific projects or program objectives.
• 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.
• Review and refine pharmaceutical reimbursement and purchasing procedures.
• Develop materials to communicate pharmacy benefit or other information to members, clinicians, and pharmacists.

Experience and/or Education

Required

• Graduate of an accredited pharmacy program
• Current, unrestricted license as a pharmacist in Oregon
• Advanced pharmacy training (PharmD, residency, fellowship, or master’s degree in related discipline)
• Practical experience as a clinical pharmacist in formulary management or ambulatory care or other clinical setting

Preferred

• Previous experience in managed care
• Experience with reviewing Prior Authorization requests against plan criteria and making approval or decline decisions

Knowledge, Skills and Abilities Required

Knowledge

• Must have comprehensive, clinical pharmaceutical knowledge base
• Knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization

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 manage multiple tasks
• Ability to negotiate, problem-solve, and consensus-build
• Basic word processing, spreadsheet, and database skills

• 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, hear, speak clearly, and perform repetitive finger and wrist movement for at least 6 hours/day

• Ability to lift and carry 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.