Pharmacist, Clinical Specialist - Infectious Diseases

Carilion Clinic•Roanoke, VA

4d•$118,789 - $190,070•Onsite

About The Position

This role involves assisting the Infectious Diseases (ID) clinic with managing OPAT (Outpatient Parenteral Antimicrobial Therapy), patients with HIV & HepC, and medication procurement for ID clinic patients. Additionally, the position supports the Specialty Pharmacy by dispensing medications, reviewing orders for accuracy, ensuring timely delivery, and overseeing billing processes. This includes verifying insurance and benefits, managing prior authorizations and appeals, documenting patient encounters, providing patient counseling on disease states and medications, developing care goals, and optimizing therapeutic outcomes. The role also involves working with pharmacy support liaisons for patient setup, accessing care management systems, performing intake of service requests, engaging with patients via telephone, and improving the patient service experience. A key aspect is conducting insurance, benefits, and financial investigations, completing prior authorization forms, negotiating with insurers, and tracking medication approvals. The position also assists in developing and implementing policies and procedures for reimbursement and accreditation standards, and facilitates staff training and competency programs.

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
Good leadership, communication, interpersonal and teamwork skills
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

Assist ID clinic with managing OPAT
Manage patients with HIV & HepC
Assist in medication procurement for patients in the ID clinic
Dispense medications and review and verify medication orders for accuracy
Assure accurate delivery of medications in a timely manner
Oversee billing of specialty medications including, verification of insurance, and benefits for Specialty Pharmacy services
Oversee completion of prior authorizations, appeals on behalf of patients and providers
Oversee the dispensing of medications to patients in a timely manner
Work 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
Document encounters and pertinent information into the software systems used by Carilion and the specialty pharmacy
Provide counseling to patients and caregivers on disease states and medications used to treat them
Develop goals for care and actively work with patients towards meeting care goals
Work with patients and providers to optimize therapeutic outcomes
Work with pharmacy support liaisons (PSLs) who provide initial patient set up to establish account with the specialty program
Access 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
Perform intake of service requests from providers or members received electronically, or via telephone or fax
Engage with patients via telephone during the onboarding process and periodically throughout the course of the patient’s therapy
Improve patient service experience and may provision prior authorization services on behalf of patients needing high-cost medications
Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients
Complete 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
Assist with the development and implementation of policies and procedures to ensure reimbursement of high-cost medications and maintenance of all accreditation standards
Facilitate staff training and competency, education and practice advancement
Maintain a training and competency program for all staff that meets accreditation standards
Coordinate with Pharmacy leadership to develop training experiences/competencies