Company :
Highmark Inc.Job Description :
JOB SUMMARY
This job works with Medicare Advantage customers who meet certain eligibility criteria to optimize their medication therapy. For those who meet eligibility criteria, the incumbent performs a comprehensive medication review (CMR). This involves talking with patients to review their entire list of medications on file, updating records to ensure current data, discussing any issues or problems related to those medications, and making recommendations based on clinical expertise. At times, the incumbent may contact physicians to discuss gaps in care discovered during the CMR, i.e. adherence issues, duplications in therapy, etc. and make recommendations. Sends a written report to the primary physician for their records, for all CMRs.
ESSENTIAL RESPONSIBILITIES
- Complete CMR (comprehensive medication review) for eligible Medicare Advantage members. This involves contacting patients telephonically to review current list of medications on record, ensure record is up to date, discuss problems/issues with medications, and make recommendations based on clinical expertise.
- Contact physicians via phone to discuss gaps in care identified through CMR (comprehensive medication review) such as adherence issues, duplication in therapy, etc. Use clinical judgement to provide recommendations to physicians.
- Create written reports summarizing the CMR (comprehensive medication review) to send to physicians.
- Other duties as assigned.
EDUCATION
Required
- Bachelor's Degree in Pharmacy
Substitutions
- None
Preferred
- Doctorate in Pharmacy
- Licensed in PA - but WV and DE is a plus as well.
EXPERIENCE
Required
- 3 - 5 years in Pharmacy (Required experience can be reduced from 3-5 to 1-2 years if the candidate completed a clinical residency program)
Preferred
- None
LICENSES AND CERTIFICATIONS
Required
- Registered Pharmacist
Preferred
- MTM Certification
SKILLS
- Oral & Written Communication Skills
- Telephone Skills
- Problem Solving & Decision Making
- Compliance
- Collaborative Problem Solving
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
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
Constantly
Lifting: 10 to 25 pounds
Occasionally
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 job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
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.
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, age, 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, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )
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