Clinical Programs Pharmacist

To design, develop, and manage clinical programs targeting high risk and high cost members, drive increased cost-savings and health outcomes through member and physician engagement, integrate seamlessly as a medication resource for care planning and case management, and independently establish infrastructure and policies that enables CCHP to scale services that exceed federal and state requirements across all lines of business. Be the primary manager of the MTM program. Essential Duties and Responsibilities The Clinical Program Pharmacist position is responsible for various responsibilities that include, but are not limited to, the following tasks Serve as lead for pharmacy to Quality Improvement department for STAR focused clinical programs, including performing or directing others to perform quality and quantity of clinical programs, including but not limited to: comprehensive medication therapy reviews, medication adherence, and statin use initiatives for Medicare member Independently develop and implement programs to provide comprehensive medication management and ensure that programs achieve high STAR performance Serve as a clinical pharmacy programs contact to all internal stakeholders, vendors, and management and acts as subject matter expert for development of clinical interventions and pharmacy programs Routinely monitor program data and metrics to evaluate program effectiveness and clinical outcomes and provide advice to appropriate committees and management. Analyze health outcomes and healthcare resource utilization directly linked to medication therapy recommendations Develop and manage policies for Drug Management Program (DMP) to ensure CMS program compliance Use pharmacotherapy expertise to independently author and revise policy use (prior authorization) guidelines for the administering of medication in compliance with regulatory requirements. Participate in the quarterly Pharmacy and Therapeutics (P&T) meetings, which includes presenting clinical drug information, analyzing drug utilization, and serving as a voting member of the P&T Committee.Serve as primary pharmacy liaison Interdisciplinary Care Team with CCHP nurses, medical social workers, and medical director for the disease management and care coordination programs, SNP-MOC, disease management, and transition of care programs. Contact physicians and pharmacies directly to ensure that pharmacologic standards of care and best practices are adhered to. Collaborate with physicians on identified medication related issues to improve patient therapy. Manage MTM contract, data validation audit, MTMP submissions and ensure timely submission and compliance to all regulations, and performance of the Five Core Elements of MTM Services Reduce reliance on external MTM vendor, particularly as regulatory requirements intensify, by independently managing MTM programs in-house. Develop policies at monthly QI Invention meetings and quarterly CCHP & Jade QI Committee meetings. Provide ad-hoc support for cross departments such as QI to ensure timely data collection are met for HEDIS measures Participate in the process of interviewing, selecting, and training candidates within the pharmacy team. Provide ad-hoc cross-coverage support for other pharmacy team members for planned absences for routine recurring duties as requested by manager. Qualifications PharmD degree and active unrestricted license in California Fluent in Cantonese and Mandarin Minimum 2-4 years related pharmacy experience (MTM experience preferred) Extensive knowledge of pharmacy workflow from prescription to claims submission and authorization request processing Strong clinical therapeutic skills and demonstration of knowledge of appropriate medication dosing in geriatric and adult populations Preferred Completion of Delivery of MTM Services Training Certificate program from American Pharmacists Association (APhA) Preferred Board Certification in Ambulatory Care or Pharmacotherapy Excellent listening skills with the ability to demonstrate empathy with patients Experience using EMRs preferred Proficient in MS Word, Excel, Outlook All positions require a pre-employment background investigation and drug screen. Physical Requirements Able to lift up to 30 pounds Use proper body mechanics when handling equipment Standing, walking and moving 50% of the day Compliance Requirements Complies with Chinese Hospital Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs. Base Pay Scale Starting at $133,245-$199,722. The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. #J-18808-Ljbffr CCHP Public Portal