Pharmacy Resident

Pharmacy Resident The main responsibilities of the Pharmacy Resident include: 1) management of pharmacy related STAR/HEIDS measures; 2) management of MTM (Medication Therapy Management) in collaboration with select health plans; 3) development of monthly quality slides and educational materials for members and providers; 4) providing coverage for medication reconciliation services, pharmacy consultation support for patients enrolled in disease management programs, medication reviews for ICT (Interdisciplinary Care Team) & Key Events, and pharmacy referral management; 5) preparing drug reviews and other clinical presentations for the Pharmacy & Therapeutics Committee.With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.Job Responsibilities/DutiesWork in collaboration with health plans to develop strategies in delivering a high STAR rating for pharmacy related measures. Implement and monitor workflows and initiatives to close clinical gaps through member and provider (physicians, pharmacies) facing interventions.Establish processes required to provide MTM services through select health plans by securing appropriate contracts, regular monitoring of patient case loads and tracking completed cases. Address any issues of discrepancy or errors with health plans and the MTM vendor. Mobilize the team of pharmacy students to conduct medication therapy management reviews through hands on training and shadowing. Review the cases performed by the students for formal approval.Develop educational materials for members and providers for 1) monthly quality calendars; 2) clinical programs (e.g., opioid management program); 3) pharmacy reports for generic prescribing; 4) ACO programs for management of specialty and non-specialty drugs; 5) ad hoc programs.Provide coverage for clinical functions performed by pharmacists 1) medication reconciliation for post-discharge members to avoid potential drug related issues including duplicate therapies or gaps in therapy; 2) pharmacy consultations for patients enrolled in the disease management programs for anticoagulation, CHF, COPD, diabetes, or CKD; 3) Key events & ICT medication reviews to address any drug-related issues and educate members on appropriate utilization of drugs. Provide support for the Pharmacy & Therapeutics Committee, Utilization Management Committee, and Quality Management Committee. Develop utilization management protocols for drugs including injectables, infusion therapies, chemotherapeutic agents, and vaccines and internal treatment algorithms. Present new drug reviews, therapeutic class reviews, drug usage guidelines, and clinical programs to the Pharmacy & Therapeutics CommitteeMinimum Education:Graduate of an accredited College of Pharmacy required.Minimum Experience:Experience in Healthcare Industry, specifically within IPA/MSO or Health Plan required. Microsoft Excel, Word, PowerPoint and good written and verbal communication skills are required.Req. Certification/Licensure:Possess a clear and active CA pharmacy license issued by the State of California Board of Pharmacy within 90 days of employment is required.