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    Clinical Pharmacist

    Pacificsource Health Plans
    0-2 years
    $125K/yr - $135K/yr
    Springfield
    10 Oct. 9, 2024
    Job Description
    Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

    About the Job

    Candidates must be located near one of the following PacificSource locations:

    • Portland, Oregon
    • Springfield, Oregon
    • Bend, Oregon
    • Boise, Idaho

    The Clinical Pharmacist will engage in all daily operations of the Pharmacy Services Department. This includes issuing pharmacy coverage decisions, developing policies and procedures, and coordinating pharmacy benefits for members. The role involves participation in the Pharmacy & Therapeutics (P&T) Committee, where you will review and present new drug evaluations, drug class reviews, and policy assessments. Ensuring compliance with all state and federal regulations is also a key responsibility. You will serve as a clinical resource for Health Services staff, internal associates, and external vendors as needed.

    Essential Responsibilities:

    • Make drug coverage determinations for members of PacificSource Health Plans.
    • Communicate effectively with members, providers, and internal staff through clinical calls, coverage determination letters, and email.
    • Support clinical meetings with both internal and external stakeholders as required.
    • Review prescription formularies and criteria for necessary updates based on clinical guidelines.
    • Participate in P&T Committee meetings by reviewing new drugs and policies, presenting materials to staff prior to meetings, and to committee members during meetings.
    • Lead or assist in assigned projects.
    • Stay informed about state and federal regulations relating to health insurance coverage.
    • Keep current on quality measures relevant to Pharmacy Services.
    • Stay updated on new and emerging clinical trends.

    Supporting Responsibilities:

    • Serve as backup for other team members and departmental functions.
    • Collaborate with the Clinical Pharmacy Manager to enhance processes, systems, reporting, and services provided by the department.
    • Represent the Pharmacy Services Department internally and externally as requested.
    • Meet departmental and company performance and attendance expectations.
    • Adhere to PacificSource privacy policies and HIPAA regulations concerning confidentiality and security of protected health information.
    • Perform other duties as assigned.

    Success Profile

    Work Experience:

    • Three or more years of pharmacy-related experience is preferred. Experience managing complex work processes and collaborating within a multidisciplinary care team is highly valued. Prior success in healthcare integration, process development, and program implementation is desirable.

    Education, Certificates, Licenses:

    • Must be a registered pharmacist with either a Pharm.D. or a Bachelor of Science in Pharmacy. Additional state-specific credentials may be required. Support for obtaining post-hire certifications may be available. Post-graduate training (e.g., Residency, Fellowship, MBA, BCPS) is preferred.

    Knowledge:

    • Ability to adapt and prioritize in a fast-paced environment with high attention to detail. Strong knowledge of pharmaceutical services, including relevant federal and state statutes and regulations. Proficient in assessing pharmaceutical alternatives, treatment plans, and new pharmacy service delivery methods. Excellent verbal and written communication skills and proficiency in Microsoft Office Suite are required. Ability to work independently and collaboratively with minimal supervision.

    Competencies:

    • Adaptability
    • Building Customer Loyalty
    • Building Strategic Work Relationships
    • Building Trust
    • Continuous Improvement
    • Contributing to Team Success
    • Planning and Organizing
    • Work Standards

    Environment:

    • Work is conducted in a general office setting with ergonomically configured equipment. Occasional travel (approximately 10% of the time) may be required.

    Skills:

    • Accountability, effective communication, flexibility, active listening, strong organizational skills, problem-solving, and teamwork.

    Our Values: We are guided by seven core values that shape our culture:

    • Commitment to doing the right thing.
    • Teamwork toward common goals.
    • Responsibility for customer service.
    • Open communication at all levels for growth.
    • Active participation in community improvement.
    • Advancing social justice, equity, diversity, and inclusion.
    • Encouraging creativity, innovation, and excellence.

    Physical Requirements:

    • Ability to stoop, bend, sit, and stand for extended periods. Repetitive motions include typing, sorting, and filing. Light lifting of files and materials may be required. Proficient in reading and comprehending written and spoken English, and able to communicate clearly and effectively.

    Disclaimer: This job description outlines the general nature and level of work performed and is subject to change. It does not encompass all duties, responsibilities, or qualifications required. Employment is at-will.

    Equal Opportunity Employment: PacificSource is an equal opportunity employer. All qualified applicants will be considered without regard to race, gender, ethnicity, religion, national origin, age, disability, veteran status, or other protected status.

    Diversity and Inclusion: PacificSource values the diversity of our workforce and is committed to creating an inclusive environment where individual differences are respected and utilized to maximize talents and strengths.

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