BlueCross and BlueShield of Massachusetts-posted 27 days ago
Full-time • Mid Level
Hybrid • Hingham, MA
Religious, Grantmaking, Civic, Professional, and Similar Organizations

The Clinical Pharmacist, Medicare Clinical Programs is responsible for providing comprehensive medication management services to improve patient outcomes. The pharmacist will also support care management with identifying and resolving drug-related problems for Medicare members. The Clinical Pharmacist will assist the Pharmacy Department in the measurement of program objectives and outcomes. This role will also be responsible for ongoing education of internal teams on various pharmacy-related topics, including Stars. The primary functions include supporting actionable pharmacy strategies that are clinically appropriate and cost-effective, while providing integrated services in collaboration with case management. This position is eligible for the flex persona. Local candidates are required to work from the Hingham office 2X per month.

  • Communicate telephonically with members to help identify and answer any drug-related questions to support medication adherence.
  • Maintain accurate and detailed records of all medication-related conversations.
  • Provide care management in reviewing and evaluating drug information for adherence, disease specific case management collaboration, medication reconciliation and polypharmacy to identify potential medication therapy problems and recommend appropriate solutions for identified patients.
  • Provide in-service education on pharmacy related topics to care management staff and other associated teams
  • Supports and participates in Medicare Case Management rounds
  • Conduct comprehensive medication reviews for eligible members, including identifying potential drug interactions, side effects, and other risk factors
  • Educate patients about their medications, conditions, and pharmacy benefits to achieve optimal participant care outcomes.
  • Collaborate with Pharmacy Benefit Manager (PBM) clinical team and internal BCBSMA departments to align priorities and execute initiatives
  • Assist in the creation and delivery of presentations and communications for various internal and external projects and meetings
  • Engage and follow-up with providers on identified interventions
  • Special projects as assigned
  • Excellent written and oral communication skills including ability to present to various audiences
  • Excellent communication skills
  • Strong organizational and time management skills, including ability to work independently and prioritize multiple projects and assignments
  • Demonstrates empathy by understanding and sharing members' feelings and perspectives, fostering trust, loyalty, and satisfaction
  • Demonstrated strength in analysis, identification of problems and issue resolution
  • Excellent skills in teamwork and team approaches to goal setting and attainment
  • Demonstrated ability to establish and maintain positive, effective working relationships with staff, internal and external customers
  • Must be results oriented.
  • Unrestricted current and valid license to practice pharmacy in the state of Massachusetts
  • Graduate of an ACPE accredited School of Pharmacy with a PharmD or related work experience
  • Minimum of 2-3 years' experience functioning as a clinical pharmacist in a managed care or hospital setting
  • Intermediate to advanced proficiency in standard computational office-suite applications including but not limited to Microsoft Word, Excel and PowerPoint and relational database manipulation is highly preferred especially with recent work-related experience.
  • Experience in direct supervision of technical support staff for clinical and/or service and operational programs is desirable.
  • paid time off
  • medical/dental/vision insurance
  • 401(k)
  • a suite of well-being benefits
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