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CareOregon · 6 hours ago

Pharmacy Clinical Coordinator (Temporary 9 months)

United States

Full-time

Remote

Mid Level

$152K/yr - $186K/yr

CareOregon is a healthcare organization focused on improving pharmaceutical use through clinical interventions. The Pharmacy Clinical Coordinator will manage pharmacy benefits, develop educational initiatives, and conduct quality improvement programs related to the pharmacy program.

Health Care

Responsibilities

Prepare drug utilization reports and analyses for the Pharmacy & Therapeutics Committee

Use an evidence-based process to perform new drug reviews, and to develop formulary recommendations and drug use criteria for the Pharmacy & Therapeutics Committee

Critically evaluate drug therapy regimens for patients enrolled in the case management program and assist with developing treatment plans

Provide medication therapy management services

Develop and conduct retrospective drug use reviews

Review medication prior authorization requests and appeals

Develop and implement clinical educational programs to improve drug utilization and quality

Review and refine policies and procedures regarding Pharmacy Department functions including medication therapy management, DUR programs, medication prior authorization, and others

Develop and conduct quality improvement programs related to the pharmacy program

Monitor functions provided by the plans’ Pharmacy Benefit Manager including pharmacy benefit coding, customer service guidelines, prior authorization activities, and other delegated services

Develop and critically evaluate pharmacy claim data analysis/reports in support of specific projects or program objectives

Assess, review, and respond to federal and state regulatory requirements/audits of the pharmacy benefit

Consult with clinicians and pharmacists to resolve pharmacy benefit issues

Review and refine pharmaceutical reimbursement and purchasing procedures

Develop materials to communicate pharmacy benefit or other information to members, clinicians, and pharmacists

Qualification

Pharmacy benefit managementClinical pharmaceutical knowledgeMedication therapy managementFormulary managementPrior authorization reviewCustomer service skillsCommunication skillsProject management skillsProblem-solving skillsWork independently

Required

Graduate of an accredited pharmacy program

Current, unrestricted license as a pharmacist in Oregon

Advanced pharmacy training (PharmD, residency, fellowship, or master's degree in related discipline)

Practical experience as a clinical pharmacist in formulary management or ambulatory care or other clinical setting

Must have comprehensive, clinical pharmaceutical knowledge base

Knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization

Ability to critically evaluate clinical pharmaceutical and medical literature and apply principles of evidence-based medicine

Ability to design and review pharmacy claims analysis/reports according to specific project requirements

Must be highly motivated and have the ability to work independently

Excellent organizational, project management, and time-management skills

Excellent written and verbal communication skills

Excellent customer service skills

Ability to manage multiple tasks

Ability to negotiate, problem-solve, and consensus-build

Basic word processing, spreadsheet, and database skills

Ability to work effectively with diverse individuals and groups

Ability to learn, focus, understand, and evaluate information and determine appropriate actions

Ability to accept direction and feedback, as well as tolerate and manage stress

Ability to see, read, hear, speak clearly, and perform repetitive finger and wrist movement for at least 6 hours/day

Ability to lift and carry for at least 1-3 hours/day

Preferred

Previous experience in managed care

Experience with reviewing Prior Authorization requests against plan criteria and making approval or decline decisions

Benefits

Medical

Dental

Vision

Life

AD&D

Disability insurance

Health savings account

Flexible spending account(s)

Lifestyle spending account

Employee assistance program

Wellness program

Discounts

Multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)

Strong retirement plan with employer contributions

PTO

Paid State Sick Time

Paid holidays

Volunteer time

Jury duty

Bereavement leave