Clinical Pharmacy Specialist Medication Care Coordination

About the Medication Care Coordination Department:

The Corewell Health Medication Care Coordination (MCC) department is a central pharmacy department consisting of clinical pharmacy specialists and pharmacy technicians working to support inpatient and outpatient infusion clinics along with select ambulatory specialty departments across medication access workflows. The MCC team supports medication pre-authorizations, system utilization management, and revenue cycle integrity with a focus on improving patient access and time to therapy for appropriate and cost-effective medication therapies authorized under insurance plans.

Scope of work:

The MCC clinical pharmacy specialist will support pharmacy technicians with medication pre-authorization completion through review of relevant clinical patient information, health plan coverage criteria, local coverage determinations set forth by CMS, clinical guidelines, and literature for indications such as oncology and specialty conditions. The clinical pharmacy specialist will also lead peer-to-peer conversations on medication authorization denials, appeals and reconsiderations and ensure streamlined communication occurs between ordering providers and health plans to limit patient care delays. The clinical pharmacy specialist will be an expert in Epic Beacon therapy and treatment plan ordering and modifications, supporting providers with transcription of medication plans and infusion clinic staff with any questions or patient escalation needs

Job Summary

Coordinates educational programs and activities designed to enhance clinical drug knowledge of staff pharmacists, physicians, nurses, other care providers. Works with staff pharmacist to increase their participation in drug monitoring, pharmacokinetics and cost containment activities. Provides pharmaceutical care to patients in assigned area of practice, implement cost containment programs, provide drug information, education and clinical services which enhance the effectiveness of drug therapy and minimize patient risk. Works with multiple medication automation systems.

Essential Functions

• Evaluates patients and orders, and takes a lead role in the ordering and interpretation of drug serum levels, using pharmacokinetic principles. Provides physicians with dosage regimen recommendations to enhance therapeutic outcomes, reduce patient’s risk, and reduce the cost of drug therapy.
• Provides drug information and educational services to hospital health care professionals, patients and families and assists staff pharmacists in responding to drug information requests. Serves as an information resource and clinical practice role model for staff pharmacists.
• Coordinates and implements departmental drug utilization review efforts and other process improvement activities as assigned.
• Ensures that processes and services are continuously monitored for quality, cost effectiveness, and efficiency. Engages in process and quality improvement activities. Makes and implements recommendations to improve operational efficiency and to implement new services for areas of responsibility.
• Facilitates applicable Pharmacy Committee activities in area of specialty and participates on other committees / task forces as member, consultant and/or chair as assigned.
• Engages in continuous study of the entire professional field to maintain the professional competence, knowledge, and skills necessary for satisfactory performance of all assigned responsibilities. Completes required continuous training and education, including department and Spectrum Health specific requirements on a timely basis.
• Coordinates the development, editing, and dissemination of departmental publications for physicians and hospital staff.
• Precepts pharmacy residents and students as assigned.

Qualifications

• Required Bachelor's Degree Science of Pharmacy or Doctor of Pharmacy degree from an accredited College of Pharmacy

• 2 years of relevant experience pharmacy experience or an American Society of Health-System Pharmacists (ASHP) Pharmacy Practice Residency Required
• 2 years of relevant experience hospital pharmacy experience or an American Society of Health-System Pharmacists (ASHP) Pharmacy Practice Residency Preferred
• ASHP accredited postgraduate year 2 (PGY2) residency in area of specialty Preferred

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