Senior Clinical Pharmacist

PacificSource-posted 3 months ago

Full-time • Senior

Boise, ID

501-1,000 employees

Ambulatory Health Care Services

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The Senior Clinical Pharmacist is responsible for providing subject matter expertise for drug coverage determinations to promote quality and cost-effective outcomes for PacificSource members. The Senior Clinical Pharmacist will identify opportunities, support, and lead continuous process improvement activities that promote lean, integrated workstreams. This role will serve as a clinical resource person for Health Services staff, other internal associates, and external vendors as necessary. This role will assist marketing and sales teams with member and broker education on pharmacy benefits.

Serve as subject matter expert in providing drug coverage determinations for members with PacificSource Health Plans.
Develop and maintain pharmacy educational materials for providers, members, and internal staff.
Work with Clinical Pharmacy Team Lead or designee to improve processes, systems, reporting, and services provided by the department.
Manage and lead clinical meetings with internal and external stakeholders as requested.
Maintain and build collaborative partnerships with key departments such as Appeals and Grievance and Health Services Utilization Management.
Manage Pharmacy & Therapeutics (P&T) Committee meetings through oversight of new drugs, drug classes, and authorization policies.
Responsible for understanding and informing the Pharmacy team on current State and Federal regulations related to health insurance coverage.
Responsible for understanding and informing the Pharmacy team on quality measures pertinent to Pharmacy Services.
Responsible for understanding and informing the Pharmacy team on relevant landscape trends.
Responsible for providing oversight and management of at least one strategic initiative.
Responsible for presenting Pharmacy materials to internal and external stakeholders.
Responsible for identifying driving workflow improvements.
Work cross-departmentally to improve transparency in priorities and move projects forward as assigned by leadership.
Assist the Clinical Pharmacy Team Leads with training new pharmacists.
Assist in Pharmacy student work, including precepting residents, pharmacy students, or other internship opportunities.

Four or more years of pharmacy related work-experience to include a minimum of two years of practice within a health plan or managed care setting.
Required to be a registered pharmacist with either Pharm D degree or Bachelor of Science in Pharmacy.
Thorough knowledge and comprehension of pharmaceutical services, including all federal and state statutes and regulations as they pertain to the insurance-related pharmacy services and benefits administration.
Ability to assess pharmaceutical alternatives, treatment plans, drug technologies and new approaches to delivering pharmacy services.
Ability to work independently with minimal supervision.
Thorough understanding of evidence based medicine and primary literature resources.
Familiar with managed care principles and applying them in daily practice.
Ability to critically evaluate medical literature.

Preference is given to longer managed care experience.
Additional experience managing complex work processes is highly preferred.
Prior success in healthcare integration, process development and program implementation is desirable.
Post-graduate training (examples include Residency, Fellowship, MBA, BCPS) is preferred.

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