Job ID: J119429
Company: Highmark Inc
Location: Home, PA, United States
Facility: Work From Home
Full/Part Time: Full time
Job Type: Regular
This role is directly responsible for the value creation, quality improvement, impact and cost control, and fiscal/ROI targets as set by the Organization via direct engagement with primary care providers (PCP) and other providers enrolled in Organization’s value based reimbursement programs, clinical care models, and continuous improvement models. The incumbent pharmacist will work directly in provider offices and will have direct clinical interaction with Highmark members who are patients in those provider practices. In this setting, the incumbent applies subject matter expertise in clinical pharmacy, pharmacy formulary, pharmacy benefit design, pharmacy policy, medical drug policy, therapeutic alternatives, medication adherence strategies, Medication Therapy Management, utilization management, immunizations, specialty pharmacy, Medicare Stars, and Medicaid HEDIS to strategies designed to promote the provider’s success in the Organization’s value based reimbursement program.
The incumbent pharmacist acts as a highly skilled subject matter expert (SME) in the Organization's value based reimbursement programs providing clinical, hands-on, office based support to assist providers in the closure of clinical gaps including, but not limited to the delivery of comprehensive medication reviews, medication adherence, post-discharge medication reconciliation, care transitions, and in recommending cost effective drug therapy regimens to prescribers within the provider practice. The incumbent will be expected to travel to provider offices within an assigned region in the Organization’s footprint and may be asked to attend and present best practices during huddle meetings within the provider practice or at periodic Local Advisory Council meetings. Further, in a matrix management environment, the incumbent works collaboratively with other functions in the provider area, data analytics, pharmacy team, and key internal/external stakeholders to provide the most appropriate support to the PCP's based upon data analysis and dashboard reports.
Frequent travel to provider offices and a valid driver’s license will be required.
Preferred (any one of the following)
LICENSES AND CERTIFICATIONS
Language (Other than English)
50% - 75%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches / trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
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