[Hiring] Clinical Pharmacy Specialist @UPMC

Role Description

UPMC Health Plan is hiring a full-time Clinical Pharmacy Specialist to support the Care Management team within the Pharmacy Services department. This is a work-from-home position, working Monday through Friday 8:30 a.m. to 5:00 p.m. EST. This is a remote position.

The Clinical Pharmacy Specialist provides clinical pharmacy expertise to the development, implementation and management of the pharmacy benefit. The clinical pharmacist assists in the management of pharmacy utilization and provides expertise in managing member care. These services will be provided in compliance with state and federal regulations, NCQA standards, the mission, policies and procedures of Health Plan and Pharmacy Department. Individual should demonstrate professionalism and commitment to meet UPMCHP goals and objectives.

Responsibilities:

• Managing and evaluating therapeutic drug interventions and other clinical pharmacy programs for the purpose of controlling pharmacy trend and improving pharmacy quality measures.
• Regularly interacting with interdisciplinary care teams to help best coordinate care for members.
• Providing innovative and applicable ideas in clinical program development, utilization management, formulary management, provider education, therapeutic substitution, MTM/DUR, and/or improvements in existing programs.
• Implementing new ideas or improvements as approved, while considering outcomes of the programs.
• Developing and conducting Drug Utilization Review (DUR) activities, Medication Therapy Management (MTM), and other integrated programs with medical management.
• Creating, developing, maintaining, and enhancing clinical reporting programs.
• Participating in meetings, committees, and work groups both internally and externally as assigned.
• Maintaining a solid understanding of the requirements of the Pennsylvania Department of Health, DPW, CMS and the National Committee for Quality Assurance.
• Ensuring compliance with regulatory and accreditation requirements of clinical functions.
• Fostering and maintaining collaborative relationships with internal and external customers.
• Communicating pharmacy information as appropriate to members, employer groups, and providers.
• Developing communication materials to providers regarding formulary changes/adherence, health education, medication compliance, and trend management.
• Mentoring students and assisting in precepting for the residency program (if applicable).
• Providing innovative ideas for new and existing clinical program development, utilization management, formulary management, provider education, and therapeutic substitution programs.
• Developing and revising various formularies for each line of business.
• Reviewing new drugs in a timely manner and submitting change forms as appropriate.
• Researching adequately and being properly prepared for all P&T Committee meetings.
• Presenting assignments succinctly and at a suitable pace, answering relevant questions.

Qualifications

• Bachelor of Science Degree in Pharmacy, and/or Doctor of Pharmacy Degree (Pharm.D.) from an accredited U.S. School of Pharmacy.
• Experience in pharmacy benefit management, insurance, managed care preferred.
• Knowledgeable in therapeutic interventions and other cost containment programs.
• Effective communication skills, both written and oral.
• Strong analytical ability and organizational skills.
• Computer literacy for pharmacy programming, word processing, data management.

Requirements

• Registration as a registered pharmacist (RPh), in the Commonwealth of Pennsylvania or eligibility for licensure by examination or reciprocity.
• Continuing Education requirements met each bi-annual cycle for re-licensure, as evident by obtaining a minimum of 30 hours of continuing education every 2 years in structured pharmaceutical education as necessary by the state board.
• Assessment of job-related skills and competency will be reviewed annually via daily functioning, job-related documentation, department-based competency programs, and continuing education activities.

Preferred Experience

• Care Management - Managed care residency or 1-3 years managed care experience or at least 3 years of direct patient pharmacy practice experience, engaging in counseling and clinical services.

Licensure, Certifications, and Clearances

• Registration as a registered pharmacist (RPh), in the Commonwealth of Pennsylvania or eligibility for licensure by examination or reciprocity.
• Continuing Education requirements met each bi-annual cycle for re-licensure.

Benefits

• UPMC is an Equal Opportunity Employer/Disability/Veteran.