At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in Healthcare. Across our family of medical centers and physician groups, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.
The primary role of the Managed Care Clinical Pharmacist Specialist is to help improve pharmacy utilization and pharmacy related quality metric scores. This role requires a strong background in Managed Care Pharmacy and Performance Improvement and is uniquely positioned to make a large positive impact to the organization. The impact supports efforts to ensure patients receive high quality preventative care and clinically appropriate cost effective treatment.
The main focuses for the position are data analysis, development of tools/processes and physician education. The areas of focus include IHA P4P/HEDIS pharmacy related quality metrics and cost effective prescribing.
Essential Functions and Responsibilities of the Job
Thorough understanding and mastery of Managed Care Pharmacy strategies, processes, and outcomes
Develop and implement programs that decrease overall drug spend for ACO and HMO lines of business
Present objective scientific rationale surrounding drug treatment recommendations
Review and analyze data to track overall drug utilization
Comprehensive knowledge of IHA quality metrics with emphasis on pharmacy related measures
Develop and implement programs to improve medication-related performance metrics (includes but not limited to monitoring patient registries, physician education, etc.)
Develop and implement patient and provider education materials/tools for both quality metrics and managed care pharmacy initiatives
Complete projects as assigned by Pharmacy and Quality Performance leadership team
Minimum of 3-5 years of experience in a managed care organization (provider group preferred)