Pharmacist, Clinical Specialist - Infectious Diseases

Carilion Clinic•Roanoke, VA

3d•Onsite

About The Position

Clinical Pharmacist for Infectious Diseases to assist the ID clinic with managing OPAT and patients with HIV & HepC, and assist in medication procurement. Support the Specialty Pharmacy by dispensing medications, reviewing and verifying medication orders for accuracy, and ensuring timely delivery. Oversee billing of specialty medications, including insurance verification and benefits for Specialty Pharmacy services. Manage prior authorizations, appeals, and dispensing of medications. Collaborate with patients, coordinators, pharmacy technicians, pharmacy support liaisons, and clinical teams to obtain necessary clinical documentation. Document encounters in software systems. Provide patient and caregiver counseling on disease states and medications, develop care goals, and work with patients to achieve them. Optimize therapeutic outcomes with patients and providers. Work with pharmacy support liaisons for patient setup. Access care management documentation systems for data entry and support programs. Perform intake of service requests. Engage with patients via telephone during onboarding and throughout therapy. Improve patient service experience and provision of prior authorization services for high-cost medications. Conduct insurance, benefits, and financial investigations. Complete and negotiate prior authorization forms and track medication approval status. Assist in developing and implementing policies and procedures for reimbursement and accreditation standards. Facilitate staff training, competency, education, and practice advancement, including coordinating training experiences with Pharmacy leadership.

Requirements

Graduate of a College of Pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE).
ASHP-accredited Pharmacy Practice Residency or 3 years of experience in clinical pharmacy.
License to practice Pharmacy in the Commonwealth of Virginia required within 90 days of hire.
Must possess good leadership, communication, interpersonal and teamwork skills.
Must be able to effectively budget time, work efficiently and accurately, and follow procedures with minimum supervision.
Excellent critical thinking and analytical skills.
Work requires knowledge of general office equipment and procedures including computer and keyboarding skills.

Responsibilities

Dispenses medications and reviews and verifies medication orders for accuracy.
Assures accurate delivery of medications in a timely manner.
Oversees billing of specialty medications including, verification of insurance, and benefits for Specialty Pharmacy services – inclusive of new referrals and therapy changes, adjudication of claims and obtaining the initial authorization for medications from commercial insurers.
Oversees completion of prior authorizations, appeals on behalf of patients and providers, and oversee the dispensing of medications to patients in a timely manner.
Works with patients, coordinators, pharmacy technicians, pharmacy support liaisons and other clinical teams to ensure that required clinical documentation is obtained prior to acceptance onto service.
Documents encounters and pertinent information into the software systems used by Carilion and the specialty pharmacy.
Provides counseling to patients and caregivers on disease states and medications used to treat them.
Develops goals for care and actively works with patients towards meeting care goals.
Works with patients and providers to optimize therapeutic outcomes.
Works with pharmacy support liaisons (PSLs) who provide initial patient set up to establish account with the specialty program.
Accesses care management documentation systems for data entry and to support the existing programs and processes by collecting information, utilizing appropriate department policies, procedures and guidelines specific to members’ eligibility, benefits and contracts.
Performs intake of service requests from providers or members received electronically, or via telephone or fax.
Engages with patients via telephone during the onboarding process and periodically throughout the course of the patient’s therapy.
Improves patient service experience and may provision prior authorization services on behalf of patients needing high-cost medications.
Conducts patient insurance, benefits and financial investigation and verification by directly communicating with patients.
Completes initial and renewal prior authorization forms, negotiate authorization status with insurers, track status of medication approval, and when necessary, alert stakeholders of denials or nonresponse.
Assists with the development and implementation of policies and procedures to ensure reimbursement of high-cost medications and maintenance of all accreditation standards.
Facilitates staff training and competency, education and practice advancement.
Maintains a training and competency program for all staff that meets accreditation standards.
Coordinates with Pharmacy leadership to develop training experiences/competencies.