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 who 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 or more 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:
Experience in writing, including research protocols, medical papers for publication, and educational pieces for patients and healthcare providers.
Experience reviewing medication evidence and clinical policy development.
Experience working in programs and services that support population health management.
Advanced skill set in Microsoft Applications, inclusive of pivot tables.
Retrieving data and conducting data driven analyses, coupled with applied therapeutics, utilizing various analytics tools, software and techniques, and hands-on experience with SQL queries, presenting findings and recommendations to broader audience, including senior leaders.
Board Certification: Board of Pharmaceutical Specialties certification.
About Providence in Oregon.
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, 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 is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. 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: Pharmacy Residency
Req ID: 304255