Medicare Advantage Clinical Pharmacist – Collaborative Drug Therapy Management (CDTM)

Mass General Brigham•Somerville, MA

38d•Hybrid

About The Position

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. The Medicare Advantage Clinical Pharmacist is responsible for optimizing medication therapy and improving health outcomes for patients enrolled in Medicare Advantage plans within the health system. This role involves direct patient care under Collaborative Drug Therapy Management (CDTM) agreements, working closely with physicians and other healthcare professionals to manage chronic conditions, ensure medication adherence, and reduce total cost of care.

Requirements

Education: Doctor of Pharmacy (PharmD) required.
Licensure: Active pharmacist license in MA & NH; CDTM certification or eligibility required.
Experience: 2+ years of clinical pharmacy experience, preferably in ambulatory care or managed care.
Familiarity with Medicare Advantage programs, Star Ratings, and MTM services.
Skills: Strong clinical knowledge in chronic disease management (e.g., diabetes, hypertension, hyperlipidemia).
Excellent communication and patient engagement skills.
Proficiency with EHR systems and data analytics tools.

Responsibilities

Clinical Care & CDTM:
Provide comprehensive medication management for patients under CDTM protocols in collaboration with prescribers.
Initiate, modify, or discontinue medications as authorized by CDTM agreements.
Monitor therapeutic outcomes, lab values, and adverse effects to ensure safe and effective therapy.
Medicare Advantage Program Support:
Conduct medication reviews for high-risk patients, including those with polypharmacy or chronic conditions.
Implement strategies to improve Star Ratings and HEDIS measures (e.g., medication adherence, statin use in diabetes, MTM completion).
May need to support transitions of care to reduce hospital readmissions and improve continuity of care.
Patient Engagement & Education:
Provide counseling on medication use, adherence, and lifestyle modifications.
Address barriers to medication access, including cost and formulary restrictions.
Interdisciplinary Collaboration:
Work closely with physicians, nurses, case managers, and social workers to coordinate care plans, if needed.
Document interventions and outcomes in the electronic health record (EHR).
Quality Improvement & Reporting:
Track and report clinical outcomes, cost savings, and performance metrics related to Medicare Advantage initiatives.
Participate in quality improvement projects and population health strategies.