Job Description

Description

: 

JOB SUMMARY

This job works as part of a product-line specific (MA, ACA, Commercial) multi-disciplinary team to close gaps in care for high-risk members.Through the multi-disciplinary team, patients who have high risk gaps in care related to medication therapy are transitioned to a Pharmacist for Case & Disease Management (CMDM).The incumbent then conducts thorough research to evaluate the patient and extensive clinical judgement and discretion to provide recommendations for closing the gap in care.The incumbent may interact with the patient or care giver, physician, and/or pharmacist through the intervention.

ESSENTIAL RESPONSIBILITIES

  • Review gaps in care for high risk patients ​ss part of a multi-disciplinary team.Conduct research including gathering claims data, reviewing clinical websites, etc. to thoroughly evaluate each patient's unique situation to provide the appropriate clinical recommendation.
  • Contact patients, care givers, physicians, pharmacists, etc. to intervene on identified gaps of care using a high level of clinical judgement and discretion.
  • Other duties as assigned.

    • EDUCATION

    Required

  • Bachelor's Degree in Pharmacy

    • Substitutions

  • None

    • Preferred

  • Doctorate in Pharmacy

    • EXPERIENCE

    Required

    Required experience can be reduced from 3-5 to 1-2 years if the candidate completed a clinical residency program

  • 5 - 7 years in Pharmacy
  • 3 - 5 years in Pharmacist - Utilization Management
  • 3 - 5 years in Pharmacist - Medical Therapy Management

    • Preferred

  • None

    • LICENSES AND CERTIFICATIONS

    Required

  • Registered Pharmacist

    • Preferred

  • None

    • SKILLS

  • Oral & Written Communication Skills
  • Telephone Skills
  • Problem Solving & Decision Making
  • Compliance
  • Collaborative Problem Solving

    • Language (Other than English):

    None

    Travel Requirement:

    0% - 25%

    PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

    Position Type

    Office-based

    Teaches / trains others regularly

    Occasionally

    Travel regularly from the office to various work sites or from site-to-site

    Rarely

    Works primarily out-of-the office selling products/services (sales employees)

    Never

    Physical work site required

    Yes

    Lifting: up to 10 pounds

    Constantly

    Lifting: 10 to 25 pounds

    Occasionally

    Lifting: 25 to 50 pounds

    Rarely

    Pay Range Minimum:

    $92,300.00

    Pay Range Maximum:

    $172,500.00

    Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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