Clinical Pharmacist (Health Plans)

Job Title: Pharmacist - Population Health
Location: Dover, DE 19901
Job Type: Full-Time
Schedule: Monday-Friday, 8:00 AM-4:30 PM or 8:30 AM-5:00 PM

Job Summary
The Population Health Pharmacist will provide clinical pharmacy support to Medicare and Commercial health plans. The role focuses on improving patient health outcomes, medication quality, STAR/HEDIS performance, and reducing unnecessary pharmacy costs.
The Pharmacist will work closely with healthcare providers and patients to identify medication-related issues, provide education, perform Medication Therapy Management (MTM), and develop strategies to improve overall patient health.

Key Responsibilities

Analyze pharmacy reports and EMR data to identify opportunities to improve patient outcomes.
Support STAR and HEDIS quality measures related to medication use.
Work with providers to improve medication management and reduce pharmacy costs.
Assess patients with specific medical conditions and identify barriers to care.
Provide patient education, self-management support, medication counseling, and MTM services.
Recommend appropriate screenings and evidence-based treatment strategies.
Develop personalized health improvement plans and follow up with patients.
Collaborate with healthcare providers on clinical quality improvement initiatives.
Maintain a 5-STAR rating of 90% or higher for assigned members.
Participate in committees, meetings, audits, and quality improvement programs.
Develop and maintain pharmacy policies and procedures in accordance with state and federal requirements.
Educate providers and health plan members about annual formulary changes.
Identify patients at risk for avoidable hospital admissions or readmissions and provide appropriate interventions.
Document patient interventions and evaluate program outcomes.
Serve as a subject matter expert on pharmacy-related clinical measures for value-based care programs.
Perform other duties as assigned.
Required Qualifications

Bachelor’s degree in Pharmacy.
Active Pharmacist license.
BPS Board Certification in a specialty such as:

• Pharmacotherapy.
• Ambulatory Care.
• Cardiology.
• Geriatrics.
• Related specialty.
• 1 year of hospital clinical pharmacist experience OR completion of an ASHP-accredited PGY-1 residency.
• Successful completion of required credentialing, if applicable.

Preferred Qualifications

• Doctor of Pharmacy (PharmD).
• Board Certification with clinical pharmacy experience.
• BPS Certification in Pharmacotherapy or another relevant specialty.
• Advanced degree such as MPH or MBA.
• 2 years of hospital clinical pharmacist experience.
• Alternatively, completion of an ASHP-accredited PGY-2 Ambulatory Care residency.

Ideal Candidate

~ The ideal candidate is a licensed, board-certified pharmacist with clinical pharmacy experience and knowledge of population health, STAR/HEDIS measures, MTM, EMR data, medication management, provider collaboration, and value-based care.