Pharmacist-Case and Disease Management

Job ID: J119798
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Apr 4, 2018

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Description

JOB SUMMARY

This job works as part of a product-line specific (MA, ACA, Commercial) multi-disciplinary team to close gaps in care for high-risk members.  Through the multi-disciplinary team, patients who have high risk gaps in care related to medication therapy are transitioned to a Pharmacist for Case & Disease Management (CMDM).  The incumbent then conducts thorough research to evaluate the patient and extensive clinical judgement and discretion to provide recommendations for closing the gap in care.  The incumbent may interact with the patient or care giver, physician, and/or pharmacist through the intervention.

  

ESSENTIAL RESPONSIBILITIES

  • Review gaps in care for high risk patients ​ss part of a multi-disciplinary team. Conduct research including gathering claims data, reviewing clinical websites, etc. to thoroughly evaluate each patient's unique situation to provide the appropriate clinical recommendation.
  • Contact patients, care givers, physicians, pharmacists, etc. to intervene on identified gaps of care using a high level of clinical judgement and discretion.
  • Other duties as assigned.

EDUCATION

Required

  • Bachelor's Degree in Pharmacy
  • Doctorate in Pharmacy (PharmD)'

Substitutions

  • None

Preferred

  • None

EXPERIENCE

Required

Required experience can be reduced from 3-5 to 1-2 years if the candidate completed a clinical residency program

  • 5 - 7 years in Pharmacy
  • 3 - 5 years in Pharmacist - Utilization Management
  • 3 - 5 years in Pharmacist - Medical Therapy Management

Preferred

  • None

LICENSES AND CERTIFICATIONS

Required

  • Registered Pharmacist

Preferred

  • None

SKILLS

  • Oral & Written Communication Skills
  • Telephone Skills
  • Problem Solving & Decision Making
  • Compliance
  • Collaborative Problem Solving

Language (Other than English)

None 

Travel Required

0%  - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office Based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Occasionally

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Rarely

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 position 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
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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