Clinical Program Pharmacist

Dated Posted: 
Friday, June 7, 2019
Organization: 
Chinese Community Health Plan
Brief job information: 
To manage clinical programs, including face-to-face medication therapy management, for 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 coordination and case management, and establish infrastructure that enables CCHP to scale services to exceed federal and state requirements across all lines of business.
Job description: 
Increase quality and quantity of clinical programs including comprehensive medication therapy reviews, medication adherence, and statin use initiatives for Medicare members to achieve high STAR performance. Implement other non-STAR related clinical initiatives including hepatitis B adherence and smoking cessation. Analyze health outcomes and healthcare resource utilization directly linked to medication therapy recommendations. Provide pharmacotherapy expertise for clinical programs by supporting the Pharmacy and Therapeutic Committee, care coordination team, prior authorization, drug utilization review and physician reporting programs. Participate in the quarterly Pharmacy and Therapeutics (P&T) meetings, which includes presenting clinical drug information, analyzing drug utilization, and serving as a member of the P&T Committee. Support drug prior authorization program by providing clinical expertise to ensure regulatory compliance on prior authorization requests. Work with CCHP nurses, medical social workers, and medical director in the disease management and care coordination programs by leveraging pharmacy data, expertise and tasks to support SNP-MOC, disease management, and transition of care programs. Contact physicians and pharmacies directly regarding pharmacologic standards of care and best practices and collaborate with physicians on identified medication related issues to improve patient therapy Serve as a clinical resource for ad-hoc medication inquiries from providers, pharmacies, and clinical staffs in CCHP. 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 CCHP Clinical Programs Pharmacist 2019. Utilize pharmacy and provider outreach to engage members, specifically for Exchange business. Position CCHP with a best practice model of clinical programs tailored to its different populations and STAR measures. Reduce reliance on external MTM vendor, particularly as regulatory requirements intensify.
Location: 
445 Pacific
Region: 
Bay Area
San Francisco
Employment type: 
Full-time
Years of experience: 
2 years
Application email: 
Required degree level: 
Doctoral Degrees