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Clinical Pharmacist Specialist
3 months ago
Now hiring a Clinical Pharmacist Specialist
Provides professional consultative services for management of the PHP pharmacy benefit for all product lines. This includes oversight of the prior authorization process, formulary management, regulatory compliance, and relationships with pharmaceutical companies. Coordinates clinical programs and services offered by the department including educational programs for members, providers, and PHP staff.Another primary function of a Managed Care Clinical Pharmacist is to work with PMG and non-PMG providers to help optimize their prescribing of drug therapy. Develop customized prescriber profiles utilizing ICIS and predictive modeling tools and present this information to our providers. Provide physicians with drug information and actively participate in the development, implementation and monitoring of the PHP drug initiatives to achieve and maintain a cost effective and appropriate drug utilization as well as optimize patient care. Decrease overall pharmacy costs for PHP
How you belong matters here.
We value our employees' differences and find strength in the diversity of our team and community.
At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us
- Full Time - Exempt: Yes
- Job is based Rev Hugh Cooper Admin Center
- Work hours: Days
- Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.
- Doctorate degree in Pharmacy (PharmD.) or Registered Pharmacist (RPh) with extensive clinical experience.
- New Mexico Board of Pharmacy License required.
- Strongly Desired - Residency or equivalent experience, three to five years experience in a Clinical Setting, residency and Board Certification
- Work with Pharmacy Department in Formulary development and maintenance, including drug/therapeutic class reviews for the Pharmacy & Therapeutics (P&T) committee and implementation of P&T Committee decisions.
- Review drug regimens of patients discharged from in-patient settings to ensure that medications are not duplicated or interact negatively and make recommendations to the provider.
- Interact with members in clinical pharmacist run medication management clinics to discuss/review polypharmacy, disease states and/or pharmacy benefits.
- Review pharmacy profiles of PHP and paneled patients for drug interactions, duplications and Preferred Drug List (PDL) compliance.
- Consult with PHP Providers to promote patient safety, quality and cost effective use of medications.
- Provides individual provider feedback, education and recommendations on cost-effective drug prescribing.
- Provides feedback on drug utilization patterns to delegated physician groups.
- Provides educational programs for members to enhance knowledge, compliance, and cost effective therapy.
- Evaluates and improves the efficiency and effectiveness of the prior-authorization process.
- Evaluates new drug therapy for possible inclusion on the formulary.
- Evaluates and authorizes non-formulary medication.
- Conducts drug utilization reviews and identify areas for improvement.
- Serves as a consultant in the development of Disease Management Pathways.
- Evaluates per member per month pharmacy costs and develops innovative mechanisms to favorably affect these costs while maintaining or improving quality of care.
- Interacts with other PHP departments to provide assistance with their functions including marketing, enrollment, provider services, and other functions as indicated.
- Supports PHP efforts in regulatory compliance as these requirements or standards relate to the pharmacy department function.
- Performs other functions as required.
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
Inclusion and Diversity Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Maximum Offer for this position is up to USD $69.72/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.