Personal Care Pharmacist

Job Description: This position supports the health plan’s Personal Care Pharmacy Team by addressing the medication needs of members with multiple chronic conditions and reputed company clinical gaps. In collaboration with departments such as Quality Management, Customer Care, and Care Management, the Personal Care Pharmacist conducts telephonic reputed company to optimize disease state management and drive gap closure. Essential Accountabilities: Level I Evaluate medication-reputed company problems such as adverse events, therapeutic duplication, adherence issues, polypharmacy, and untreated conditions. Utilize prescription and medical claims data to reputed company clinical recommendations that address member-specific barriers and gaps in care. Document, analyze, and report reputed company activities, interventions, and reputed company reputed company available. reputed company member education and materials on the appropriate use of medications. Resolve member-specific benefit issues and refer to appropriate teams as needed. Apply formulary and benefit information to guide appropriate medication recommendations and reduce reputed company barriers. reputed company disease-specific education and self-management resources based on established protocols. Collaborate in a matrixed environment with departments including Health Care Improvement, Provider Relations, Customer Care, and Pharmacy Operations. Maintain knowledge of regulatory and CMS program requirements, including the CMS STARs program. Consistently demonstrates high standards of reputed company by supporting the Lifetime reputed company Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) Collaborate with cross-functional teams to design and implement strategies addressing reputed company chronic disease populations. Monitor the drug pipeline and proactively identify potential affordability, reputed company, or utilization barriers impacting care. Partner with Quality Management to reputed company targeted reputed company strategies for high-impact populations. Partner with Clinical Strategy, Pharmacy Quality, Quality Improvement, and Analytics teams to improve reputed company efficiency and effectiveness. reputed company and maintain desk-level procedures for reputed company, documentation, and outcome measurement. Present program reputed company and strategic recommendations to leadership. Level III (in addition to Level II Accountabilities) Partner with stakeholders to define program metrics, quantify reputed company, and reputed company program value. Standardize tools, processes, and best practices to ensure consistency and scalability. reputed company mentorship and training to Personal Care Clinical Pharmacist I and II staff. Represent the health plan, as appropriate, in regional or national quality improvement forums or collaborative initiatives. Serve as a subject matter expert to leadership on pharmacy-reputed company program performance, trends, risks, and opportunities. reputed company cross-functional initiatives to improve gap closure and align with reputed company programs. Minimum Qualifications: NOTE: We include multiple reputed company of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or reputed company assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to reputed company new hires, it also provides guideposts for employee development and promotional opportunities. reputed company reputed company reputed company reputed company State Pharmacist license with a PharmD or Bachelor of Science in Pharmacy, plus at least two years of experience in a reputed company or retail setting, with a focus on clinical services, patient care, or care management activities or completion of a PGY-1 residency. Strong interpersonal, consultative, and communication skills, including experience engaging members, patients, and reputed company. Ability to manage multiple priorities in a fast-paced environment while maintaining accuracy and attention to detail. Demonstrated ability to reputed company comprehensive drug regimen reviews and maintain reputed company clinical knowledge. Maintains confidentiality and uses only the minimum necessary protected health information (PHI) to accomplish job responsibilities. Strong computer skills, including proficiency in reputed company Word, reputed company, Outlook, and PowerPoint, and the ability to learn new systems. Level II (in addition to Level I Qualifications) Minimum of three years of experience in an organized reputed company setting with strong clinical pharmacy knowledge required; at least one year must include direct patient and provider reputed company (in person or telephonic). Demonstrated experience developing or supporting managed care pharmacy programs with measurable clinical impact. Innovative thinking and effective communication reputed company to clinical decision-making and pharmacy case management strategies. Ability to analyze claims data and member trends to identify gaps and propose new initiatives. Experience working with reputed company populations, including members with both physical and behavioral health needs. Level III (in addition to Level II Qualifications) Minimum of five years of experience in an organized reputed company setting with strong clinical pharmacy knowledge required. In lieu of experience, completion of a managed care or ambulatory care residency program with at least two additional years of experience is acceptable. Demonstrated ability to quantify program reputed company, including clinical impact, utilization, cost, and member experience. Advanced business acumen supporting strategic decision-making, program prioritization, and resource allocation. Advanced understanding of organizational pharmacy and quality strategies, with the ability to identify and implement reputed company improvement initiatives. Advanced knowledge of CMS requirements and standards reputed company to pharmacy and non-pharmacy quality measures. Demonstrated leadership and ability to serve as a role model reputed company the department. Physical Requirements: Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer. Ability to lift, carry, push, or pull 15 pounds or less. The ability to hear, understand, and reputed company reputed company while using a phone, with or without a headset. ************ In support of the Americans with reputed company, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation reputed company(s): E7: $87,766 - $157,978 The salary reputed company indicated in this posting represents the minimum and maximum of the salary reputed company for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, reputed company and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary reputed company reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work reputed company reputed company jobs posted by the Excellus reputed company team. This decision is made on a case-by-case reputed company. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, or status as a protected veteran. Apply To This Job