Clinical Pharmacist II-Paramount Health
Posted 2025-03-14About the position
The Clinical Pharmacist II at Medical Mutual plays a crucial role in enhancing pharmaceutical care and improving medication quality measures for members. This position involves developing and implementing clinical programs, engaging with health systems, and collaborating with various internal departments to ensure cost-effective medication management. The pharmacist will also support formulary and policy development, address adherence gaps, and assist in sales efforts related to pharmacy services.
Responsibilities
? Develops policies and strategies to engage members and/or providers and help drive improvements in pharmaceutical care and pharmacy quality measures to decrease drug spend.
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? Addresses Medicare STAR drugs adherence gaps.
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? Reviews drug/medical literature, clinical practice guidelines, quality measures, and available national guidelines to support formulary, drug policy or drug therapy interventions and creation of new initiatives.
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? Interacts with PBM/vendor oversight activities including regular or ad-hoc audits of clinical programs.
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? Develops and implements programs to communicate and educate internal staff, external brokers, strategic health systems, pharmacy chains and provider groups.
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? Performs Consumer Assessment of Healthcare Providers and Systems (CAHPS)-focused interventions to improve drug plan perception.
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? Promotes the value-add of the Company's pharmacy services with internal and external stakeholders.
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? Assists Sales in selling and renewing pharmacy services, or retaining business, by attending meetings, promoting pharmacy benefits and services, developing responses to Request for Proposal (RFP), recommending solutions to brokers and their clients.
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? Collaborates with pharmacy departments within the Company's strategic health systems, pharmacy chains and provider groups to implement programs which better engage members to improve overall medication quality performance and cost of care.
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? Assists in closing Medicare STARS-related gaps by completing Comprehensive Medication Reviews (CMRs), Medication Reconciliation Post-Discharge (MRPs), and In-Home Assessments (IHAs).
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? Partners with internal departments including Medicare STARS, Clinical Quality Health Services, Provider Network Management, HEDIS, and Customer Care to develop and implement programs and clinical initiatives to support achievement of strategic goals.
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? May orient, train, and assist new hires, residents, and junior level Pharmacists.
Requirements
? Doctor of Pharmacy (Pharm.D.) preferred; Bachelor of Pharmacy with relevant experience may be considered.
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? 3 years of experience as a Clinical Pharmacist or equivalent experience in a managed care pharmacy setting.
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? Registered Pharmacist with current unrestricted license from the appropriate State Board of Pharmacy; may be required to obtain Ohio State Board of Pharmacy license within 6 months of hire.
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? Understanding of managed care pharmacy, including formulary design/management, drug utilization management, and/or quality assurance programs.
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? Knowledge of medical/pharmacy terminology/coding and specialty drug management.
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? Good clinical acumen and strategic analysis skills.
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? Microsoft Office skills specifically Excel and Pharmacy Benefit Management (PBM) systems; basic proficiency with Visio and/or Access.
Nice-to-haves
? Medicare/Medicaid experience preferred.
Benefits
? Employee bonus program.
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? 401(k) with company match up to 4% and an additional company contribution.
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? Health Savings Account with a company matching contribution.
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? Excellent medical, dental, vision, life and disability insurance.
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? Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
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? Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
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? Parental leave for eligible employees who become parents through maternity, paternity or adoption after 120 days of service.
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? Career development programs and classes.
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? Mentoring and coaching to help you advance in your career.
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? Tuition reimbursement up to $5,250 per year.
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