Clinical Pharmacist at Prospect Medical Holdings, Inc. in Johnston, Rhode Island

Job Description:

The Clinical Pharmacist is accountable for closing payer clinical care gaps, providing medication therapy management (MTM) for high risk patients, and providing physician and patient support .\n
\n Prospect Medical Holdings' ability to deliver quality, compassionate care during the unprecedented pandemic affirms the original vision of its founders. This is the fulfillment of the hopes Prospect's founders had for the company, and proof that a clear vision, an insightful operating model, and a commitment to communities and our employees, born in the past, remains the way of the future. \n
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\n Every day, our more than 11,000 affiliated physicians and 18,000 employees at 17 hospitals, 165 outpatient centers and 28 medical groups provide nationally recognized care in six states. Our comprehensive network of quality healthcare services is designed to offer our patients and 600,000 members highly coordinated, personalized care tailored to the unique needs of each community we serve-many of which provide essential medical services to underserved communities as safety-net hospitals. \n
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• Prior experience of providing MTM action plans for patients and providers in ambulatory care settings required.
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• Prior pharmacy residency program or managed care/ambulatory care experience (e.g., health plans, pharmacy benefit management companies, medical groups) preferred.
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• Board Certification (Board Certified Pharmacotherapy Specialist, Board Certified Geriatric Pharmacist) preferred.
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• Graduate of an accredited School of Pharmacy recognized by the State Board of Pharmacy required. Pharm.D. and post-doctoral residency preferred.
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• Licensed by the State Board of Pharmacy required.
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• Close clinical gaps to improve CMS STAR ratings/HEDIS measures. Review payer reports as received to identify trends and create monthly action plan.
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• Follow developed workflows to improve quality measures by collaborating with patients, pharmacies, and providers to resolve gaps in care. Track KPIs for care gap measures. Participate in clinical payer-provider meetings.
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• Provide comprehensive medication reviews and targeted interventions for eligible patients. Identify and resolve medication issues in collaboration with prescribers and patients. Address opportunities to optimize therapy/transition home.
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• Document communications with physician offices and patients regarding pharmacy recommendations in appropriate EHR & care management systems.|Facilitate collaboration with hospital pharmacy department to optimize medications for high-risk patients before being discharged.
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• Perform medication reviews for high-risk homebound patients when appropriate. Attend physician/office manager meetings monthly.
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• Serve as a resource to suggest pharmacotherapy alternative to enhance compliance, reduce potential errors/adverse drug events, and minimize cost burden.
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• Develop educational tools (e.g., health plan formulary information, newsletters, bulletins). Provide support for implementing/implement clinical pharmacy programs.
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• Participate in pod meetings to inform leaders of relevant pharmacy initiatives and information.
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\n
• Close clinical gaps to improve CMS STAR ratings/HEDIS measures. Review payer reports as received to identify trends and create monthly action plan.
\n
• Follow developed workflows to improve quality measures by collaborating with patients, pharmacies, and providers to resolve gaps in care. Track KPIs for care gap measures. Participate in clinical payer-provider meetings.
\n
• Provide comprehensive medication reviews and targeted interventions for eligible patients. Identify and resolve medication issues in collaboration with prescribers and patients. Address opportunities to optimize therapy/transition home.
\n
• Document communications with physician offices and patients regarding pharmacy recommendations in appropriate EHR & care management systems.|Facilitate collaboration with hospital pharmacy department to optimize medications for high-risk patients before being discharged.
\n
• Perform medication reviews for high-risk homebound patients when appropriate. Attend physician/office manager meetings monthly.
\n
• Serve as a resource to suggest pharmacotherapy alternative to enhance compliance, reduce potential errors/adverse drug events, and minimize cost burden.
\n
• Develop educational tools (e.g., health plan formulary information, newsletters, bulletins). Provide support for implementing/implement clinical pharmacy programs.
\n
• Participate in pod meetings to inform leaders of relevant pharmacy initiatives and information.
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