Providence Health & Services Senior Clinical Pharmacy Specialist - Managed Care in Beaverton, Oregon
Providence St. Joseph Health is calling a Senior Clinical Pharmacy Specialist - Managed Care to our location in Beaverton, OR.
We are seeking a Senior Clinical Pharmacy Specialist - Managed Care to an expert in medication utilization and pharmacy therapeutic, utilization and economic data. The Senior CPS will collaborate with analytics, nurse case managers, medical directors, network physicians and senior pharmacy leadership in identifying, developing and leading execution of key strategies and tactics to support total cost of pharmaceutical care and population health.
The responsibilities of the Senior CPS predominantly fall into the following areas: (1) Apply therapeutic knowledge and analytic acumen to collaborate with analytics and care management programs to lead tactical development and execution of cost-effective, high quality and clinically relevant pharmacy programs and services (2) Provide pharmacy and medical trend insights while analyzing opportunities to optimize formulary, utilization management, innovative pricing and emerging rebate opportunities (3) Clinical and analytical evaluation of medication pipeline, supporting clinical policy development and application for our populations and clients (4) Development and execution of customized solutions for clients and groups that is meaningful and market differentiating in high quality, total cost of care driven for members. (5) Support pharmacy rebate and network programs through pricing and contracting strategies (6) Research and explain clinical and business aspects of drugs and associated strategies to internal business partners (7) Contribute and participate in clinical and/or financial meetings that manage drug and class review, supporting RFP development, group proposals and reviews, Pharmacy & Therapeutics Committee, and physician engagement and prescribing detailing.
In this position you will have the following responsibilities:
Develops and implements initiatives across all lines of business to support quality and cost-effective initiatives and programs
Provide trend insights and identify areas for improvement and management of individual medications and/or medication classes
Interface with and collaborate with internal departments on opportunity or clinical program development
Skilled in dashboard development and maintenance that supports ongoing assessment and communicates value of programs and service within the pharmacy division.
Effectively communicate verbally and/or in writing regular communication of clinical pharmacy functions to multidisciplinary team members and other health care professionals including physicians, pharmacists, nurses and others who may be participating in a patient's care.
Participates in educational activities and programs for health plan professional staff using effective and appropriate teaching methods.
Performs drug utilization management functions and initiatives including medical drug policy generation, review, and application including prior-authorization, general DUR, and population and group level initiatives and educational programs to improve safety and quality in the provision of drug therapy.
Serves as a resource person to physicians and nurses requesting clinical pharmacy services support.
Participates in meetings of the MTM team, pharmacy department, QMM department, PHP all-staff, and other groups and committees as assigned.
Coordinates ongoing quality assurance evaluations of clinical pharmacy services activities and implements necessary action as appropriate.
Skilled in Microsoft applications and SQL, with ability to analyze and manipulate complex datasets and make recommendations
Participates in educational activities including, but not limited to, patient education, provider and staff presentations, newsletters and evidence-based literate reviews as assigned.
Manage communications for members, clients, prescribers, pharmacies and internal stakeholders regarding programs and services.
Required qualifications for this position include:
Graduate from an accredited College or School of Pharmacy or Bachelor's or MS Degree in pharmacy considered with 5 or more years of managed care experience with documented responsibility for evidence and clinical case review and direct consultation of medication information with physicians and/or patients.
Completion of a PGY-1 Residency.
Completion of specialty/PGY-2 in Pharmacy Outcomes/Healthcare Analytics or 3 years experience in pharmacy outcomes and healthcare analytics with documented responsibility for utilizing pharmacy data that supports trend management, pharmacoeconomic evaluations, and initiative/program development and execution.
Current registration and licensure by the Oregon State Board of Pharmacy or the ability to obtain licensure prior to employment.
Preferred qualifications for this position include:
- Board of Pharmaceutical Specialties certification
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Pharmacists
Req ID: 265908