Clinical Pharmacist Specialist II

PacificSource • Portland, OR

6d • Onsite

About The Position

The Clinical Pharmacist Specialist II supports PacificSource’s mission to provide better health, better care, and better cost to the people and communities we serve by coordinating the delivery of pharmaceutical services based on the member’s specific clinical circumstances, health plan benefits, and availability of additional medical, community, or financial resources. This role provides subject matter expertise for specialized pharmacy processes and programs, such as formulary administration, Pharmacy and Therapeutics Committee work, or initiatives that promote the overall quality of the health plan. The Clinical Pharmacist Specialist II will identify opportunities and lead continuous process improvement activities that promote lean, integrated workstreams. This role will serve as a clinical liaison for other departments and external vendors as necessary, and may provide information or education on pharmacy services.

Requirements

• Minimum of 4 years of managed-care pharmacist work experience is required with demonstrated excellence in deliverables and successful collaboration.
• Doctor of Pharmacy degree or Registered Pharmacist, and valid state license without restriction required.

Nice To Haves

• Additional experience managing complex work processes is highly preferred.
• Prior experience in healthcare integration, process development and program implementation is preferred.
• Post-graduate training (examples include Residency, Fellowship, MBA, BCPS) is preferred.
• Additional certifications may be needed such state specific credentials.

Responsibilities

• Provide subject matter expertise in a specialized pharmacy process (such as formulary management, quality or population health initiatives, or Pharmacy and Therapeutics Committee reviews) and effectively collaborate with internal partners to maximize deliverables.
• Work with Pharmacy Leadership to strategically improve processes, systems, reporting, and services provided by the department.
• Lead or support clinical meetings with internal and external stakeholders as requested.
• Lead or assist in projects as assigned.
• Assist with resident training.
• Assist training pharmacy staff in specialized workflows as assigned.
• Collaborate with pharmacy leadership to create and maintain training documents
• Stay up to date on State and Federal regulations as they relate to health insurance coverage and the practice of pharmacy.
• Stay up to date on quality measures pertinent to Pharmacy Services.
• Provide effective communication for members, providers, and internal staff through various platforms such as clinical calls, coverage determination letters, and email.
• Act as backup for other team members and departmental functions.
• Provide accurate and timely drug coverage determinations for members of PacificSource Health Plans based on posted criteria, current standards of medical practice, and member-specific condition.
• Assist Medical Directors in reviewing appeals for denied coverage determinations.
• Represent Pharmacy Services Department, both internally and externally, as requested
• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

Benefits

• Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level