Sr Pharmacist, Care Management

Job ID: J161037
Company: Gateway Health Plan
Location: Remote
Full/Part Time: Full time
Job Type: Day (United States of America)
AHN Facility:
Posted Date: May 7, 2020

JOB DESCRIPTION

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job will works in a team oriented environment. The incumbent works with Gateway Health members on a daily basis to improve engagement and subsequent outcomes as an adjunct to health coaching; will develop and implement physician, pharmacy and member educational initiatives that promote Gateway’s formularies, utilization management programs, and case/disease management initiatives; and will participate in cross-functional committees to develop and implement clinical and operational initiatives. The incumbent may also provide consultation into the case and disease management identification process and consult with Gateway medical directors when appropriate.

ESSENTIAL RESPONSIBILITIES

  • Work one-on-one with Gateway members via face-to-face and/or telephonic interactions. Develop care plans for individual members, coordinate member’s care and assist in the discharge planning process.
  • Represent the organization to members, providers, and other staff at participating practices.
  • Assist in the development and implementation of various programs, including, but not limited to utilization management, disease management and chronic condition management.
  • Address gaps in care, medication adherence and perform medication reconciliation.
  • Collaborate with Gateway Health and providers to promote appropriate and cost effective use of medications through adherence to formulary and utilization management requirements.
  • Support Gateway Health initiatives to reduce emergency department utilization as appropriate.
  • Collaborate with providers and other staff to develop and implement physician, pharmacy, and member educational initiatives that promote Gateway’s formularies, utilization management programs, and case/disease management initiatives.
  • Participate in cross-functional committees to develop and implement clinical and operational initiatives within the pharmacy department.
  • Identify and assist in managing department process improvements to maximize overall efficiencies.
  • Other duties as assigned or requested.

EDUCATION

Required

  • Bachelor of Science in Pharmacy or a Doctor of Pharmacy degree

Substitutions

  • None

Preferred

  • None

EXPERIENCE

Minimum

  • 5 – 7 years of post-graduate pharmacy experience

Preferred

  • 1 – 3 years of related, progressive clinical experience in ambulatory care (as part of three year post-graduate pharmacy experience)
  • Experience with Medicaid populations
  • Post Graduate Year 1 (PGY1) residency with concentration in ambulatory care

LICENSES OR CERTIFICATES

Required

  • Registered Pharmacist

Preferred

  • Board Certified Pharmacotherapy Specialists (BCPS)
  • Board Certified Ambulatory Care Pharmacist (BCACP)

SKILLS

  • Strong verbal and written communication skills
  • Microsoft Office (Outlook, Word, Excel)
  • Managed care experience with fundamental understanding of formulary management and utilization management concepts
  • Quickly identify and prioritize issues and requests
  • Prepare and present presentations to stakeholders
  • Appropriately follow up with measurable outcomes

Language Requirement (other than English)

None

Travel Required

0% – 25%

Physical, Mental Demands and Working Conditions

Position Type

Office-Based

General Description for Office-Based Positions

Office-Based: An employee in this position works in an office environment. The position frequently requires the employee to communicate well with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.

Teaches / trains others regularly

Occasionally

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

Frequently

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

Does Not Apply

Physical work site required

No

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.

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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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BENEFITS

Total Rewards Program

In addition to competitive pay rates and flexible career growth, we show our employee appreciation through a comprehensive Total Rewards package, including:

  • Medical and prescription drug, dental and vision coverages for your and your eligible dependents
  • Health Saving and Flexible Spending Accounts
  • Life, AD&D and disability insurance
  • Employer-sponsored 401(k) plan
  • Paid time off, including paid holidays
  • Tuition reimbursement
  • Volunteer opportunities
  • Voluntary benefits
  • Employee discounts
Wellness Resources and Programs
Employees have access to the following wellness programs and resources:
  • Work-life resources, such as employee assistance programs and financial counseling services
  • 24/7 telephone access to health and wellness coaching to achieve personal goals
  • Onsite pharmacy services at major campuses
  • Fitness center access for all employees inclusive of showers, lockers, and group exercise classes at major Highmark campuses, Allegheny General Hospital & West Penn Hospital
  • Access to chronic condition management programs when enrolled in the employer-sponsored medical plan
  • 100% coverage for preventive exams, including flu shots
  • Incentive program that rewards employees
  • Secure bicycle parking at major campuses
  • Healthy food options at onsite cafeterias
  • Employee networks to gather in the name of health
  • Onsite seated massage and stress management classes including yoga, mindfulness and meditation

LIVING IN PITTSBURGH

Pittsburgh, PA is home to Highmark Health’s corporate headquarters, as well as the headquarters of many of our businesses and a majority of our career opportunities. When you live and work in Pittsburgh, you’ll experience a wide variety of lifestyle advantages. Take a look around and you’ll quickly see why Pittsburgh is one of America’s most liveable, most affordable, safest and happiest cities. Learn more about this exciting and inviting location:

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