Clinical Pharmacist, MTM

This is a fully remote position, open to applicants in North Dakota, +3 more states.

📋 Description

• Assist in initiatives aimed at addressing care gaps through direct outreach to providers and members, collaborating with provider engagement, and utilizing our pharmacy network capabilities.

• Ensure that all suggestions align with the most recent guidelines or are otherwise backed by clinical compendia.

• Offer clinical pharmacy support to pharmacy technicians as they reach out to members concerning medication adherence, address existing barriers, and apply motivational interviewing techniques to enhance member health.

• Work collaboratively with internal teams such as Marketing, IT, and Enterprise Analytics to help develop strategic digital communication channels for member outreach.

• Identify and promptly address same-day grievances reported by members in accordance with our policies and procedures.

• Supervise and ensure compliance with all state and federal regulations.

• Mentor Pharmacy Residents and Students.

• Guarantee that all clinical criteria adhere to the standards set by the Centers for Medicare and Medicaid Services (CMS) and the New York State Department of Health (NYSDOH).

• Conduct research on drug information to stay updated on medication knowledge and disease state comprehension.

• Analyze monthly reports and provide insights on trends, efficiency improvements, and innovative ideas.

• Perform additional duties as assigned or necessary.

⛳️ Requirements

• A pharmacy degree from an accredited institution.

• A Registered Pharmacist with a state license in good standing.

• Experience in written and verbal clinical communication that is clear, concise, grammatically correct, and professional.

• Understanding of specialty pharmaceuticals and billing practices within medical and pharmacy benefits.

• Bilingual proficiency in English and one or more additional languages: Spanish, Mandarin, or Cantonese may be required based on business needs.

• Ability to thrive in a team environment and collaborate effectively with colleagues.

• Proven critical thinking and problem-solving abilities.

• A strong desire to learn, advocate for the pharmacy profession, and an interest in developing skills in a dynamic environment with various opportunities.

• Familiarity with the regulations of the Centers for Medicare and Medicaid Services, including but not limited to National and Local Coverage Determinations.

• Capability to lead both large and small group meetings.

• Proficient in PC skills, including Microsoft Outlook, Word, PowerPoint (for creating presentations and slides), and Excel (including pivot tables).

🏝️ Benefits

• Medical, dental, and vision coverage.

• Incentive and recognition programs.

• Life insurance.

• 401k contributions.