Population Health Clinical Pharmacist

Banner Pharmacy Services-posted 4 months ago

Full-time • Mid Level

Phoenix, AZ

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As a Population Health Clinical Pharmacist, you will support value based care work and be able to effectively communicate with patients and providers. You will collaborate with the healthcare team to identify and address pharmacy related Stars measures and assist with pharmacy initiatives related to cost savings and improved patient care. You will also oversee daily activities of pharmacy technicians. Population health work experience with focus on value based care and managed care will be helpful in this role. Ability to obtain Colorado Pharmacist licensure will be needed. Your hours will be Monday - Friday, 8AM - 5PM working remotely. Banner Pharmacy Services is a recognized leader in healthcare and trusted partner in proactively providing innovative pharmacy services through excellence in integration, care coordination, medication management and services to make a difference in people's lives. Clinical Pharmacy Services is responsible for the management of the Banner formulary, development of standardized system wide clinical pharmacy services, and management of adverse drug event preventions. Clinical Pharmacy Services provides collaborative drug therapy management and educational interventions in patient care to optimize medication therapy, improve outcomes, promote wellness, and disease prevention. As a division, Banner Pharmacy services provides excellent patient care across our entire continuum through convenient access, improved medication outcomes and innovative pharmacy practices.

Provides management of pharmacy services to Insurance Division members, including commercial, Medicare, Medicaid populations within owned/operated health plans as well as value-based agreements.
Identifies and stratifies members based on complex pharmaceutical care needs to optimize pharmacotherapy regimens at the patient/member level, and population level to improve overall healthcare quality and reduce costs.
Analyzes and interprets pharmacy and medical claims reporting and other sources of clinical and economic data to generate insights and clinical service opportunities.
Active participant and/or leader in defining, implementing, and managing clinical programs and services that improve pharmaceutical care quality and lowers costs.
Maintains proficiency in all legal, regulatory, and practice standards related to CMS, AHCCCS, or out-of-state Medicaid programs.
Conducts utilization management reviews and adjudicates prior authorization requests and appeals.
Communicates with and supports Insurance Division members and network providers and support staff, Health Plan leaders, and Insurance Division executives concerning pharmacy issues and programs and services.
Applies the principles of continuous quality improvement consistent with job expectations.
May be assigned to collaborate with technical experts to create data extracts of pharmacy, eligibility, provider, or medical claims data for health plan pharmacy utilization management and audit functions.
Participates in student and resident learning experiences, including as primary and supportive preceptor as assigned.

Must possess a degree in Pharmacy (advanced degree preferred) from an accredited College of Pharmacy.
Completion of an accredited PGY1 pharmacy residency program or three years of previous clinical pharmacy experience in the managed care, community pharmacy, or ambulatory care setting.
Requires current and unrestricted pharmacy licensure in the applicable state of practice within 90 days of hire date.
Requires a proficiency level in managed care/health plan or pharmacy benefits experience typically obtained in 2 years.
Requires effective human relations and verbal/written communication skills and the ability to work collaboratively with community-based practitioners and the senior population.
An understanding of the interrelationships of health plan pharmacy components, members, and providers is required.
Proficiency with PC based productivity tools (e.g. spreadsheets, word processing, e-mail) required.
Needs analytical ability to support decision making; organizational ability to manage multiple tasks and projects by established deadlines.

Geriatric certification is a plus.
Experience with Medicare Part D is a plus.
Additional related education and/or experience preferred.

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