Population Health Management Pharmacist - CarelonRx
About the position
The Population Health Management Pharmacist at CarelonRx is responsible for managing the selection and utilization of pharmaceuticals while supporting core clinical programs for contracted provider groups. This role focuses on achieving quality and cost goals through effective medication management and collaboration with healthcare providers.
Responsibilities
Ā Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.
,
Ā Serves as a clinical resource to other pharmacists and contracted providers in areas such as prospective, inpatient, and retrospective DURs and clinical support for therapeutic interventions.
,
Ā Prepares information for network physicians using data within provider tools including Excel.
,
Ā Evaluates pharmacy quality program data and works with stakeholders to identify, prioritize, and implement strategies to optimize medication use and manage pharmacy spending effectively.
,
Ā Acts as a subject matter expert in pharmacy-related clinical measures for value-based care agreements during practice-level discussions.
,
Ā Works to improve pharmacy quality by staying up to date on STAR and HEDIS measures.
,
Ā Provides education to providers to support clinical pharmacy measures and reduce pharmacy costs.
,
Ā Builds impactful relationships with providers to close the feedback loop between pharmacy and provider.
Requirements
Ā Requires BA/BS in Pharmacy.
,
Ā Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.
,
Ā Requires a registered pharmacist.
,
Ā Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
Nice-to-haves
Ā PharmD preferred.
,
Ā Experience in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures strongly desired.
,
Ā Experience working with Medicare and Commercial providers strongly preferred.
,
Ā PBM or Managed Care experience highly desired.
,
Ā Proficiency with Excel preferred.
Benefits
Ā Comprehensive benefits package
,
Ā Incentive and recognition programs
,
Ā Equity stock purchase
,
Ā 401k contribution
Apply Now
The Population Health Management Pharmacist at CarelonRx is responsible for managing the selection and utilization of pharmaceuticals while supporting core clinical programs for contracted provider groups. This role focuses on achieving quality and cost goals through effective medication management and collaboration with healthcare providers.
Responsibilities
Ā Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.
,
Ā Serves as a clinical resource to other pharmacists and contracted providers in areas such as prospective, inpatient, and retrospective DURs and clinical support for therapeutic interventions.
,
Ā Prepares information for network physicians using data within provider tools including Excel.
,
Ā Evaluates pharmacy quality program data and works with stakeholders to identify, prioritize, and implement strategies to optimize medication use and manage pharmacy spending effectively.
,
Ā Acts as a subject matter expert in pharmacy-related clinical measures for value-based care agreements during practice-level discussions.
,
Ā Works to improve pharmacy quality by staying up to date on STAR and HEDIS measures.
,
Ā Provides education to providers to support clinical pharmacy measures and reduce pharmacy costs.
,
Ā Builds impactful relationships with providers to close the feedback loop between pharmacy and provider.
Requirements
Ā Requires BA/BS in Pharmacy.
,
Ā Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.
,
Ā Requires a registered pharmacist.
,
Ā Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
Nice-to-haves
Ā PharmD preferred.
,
Ā Experience in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures strongly desired.
,
Ā Experience working with Medicare and Commercial providers strongly preferred.
,
Ā PBM or Managed Care experience highly desired.
,
Ā Proficiency with Excel preferred.
Benefits
Ā Comprehensive benefits package
,
Ā Incentive and recognition programs
,
Ā Equity stock purchase
,
Ā 401k contribution
Apply Now