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 anal