Clinical Pharmacist - Remote (PA/NJ/DE)
Under the direction of the Manager, Case Management works with members/providers to address and optimize members medication profiles. The associate will focus on assessing, and monitoring member’s drug therapies. The associate identifies issues, makes recommendations works with the health care team and implements interventions. The Clinical Pharmacist facilitates communication and serves as a liaison and educator between the member, family, the Plan, and all members of the health care team, thus promoting high quality, cost-effective services.
Duties and Responsibilities:
Responsible for evaluating members entire medication profile and optimizing member’s drug therapy
Appropriately contacts and assesses the member to identify and resolve medication gaps
missing medication and affordability issues
prior auth issues and appeals
Address Polypharmacy and works to reducing the number of medications to increase adherence.
The associate optimizes the member’s benefit by promoting effective and efficient use of health care / Pharmacy resources.
Address inappropriate/missing medications
Educate on benefits, formulary
Routinely provides members with proper information for the safe and effective use of medications
Drug therapy optimization, ensuring proper drug dosage and cross-drug utilization
Improve medication adherence
address patient/family concerns/questions, and provide education on pharmacotherapy
Adverse side effect mitigation
Drive towards most cost-effective medications
Reduce pharmacy and medical spend
Coordinate recommendations with nurse health coach and member’s providers
Monitors the effectiveness of the Medication plan and documents interventions and follow-up
Accurately documents within the manage care system, utilizing appropriate standard templates and identifies themselves as the Clinical pharmacist working with the member.
The associate develops a strong understanding of community resources with may be recommended to support the member/family beyond the Plan’s benefit parameters
The associate provides exceptional customer service to all internal and external customers.
- Maintains current knowledge necessary to provide pharmacy services of the highest standards
Other duties as assigned
Required Qualifications:
- Doctor of Pharmacy or Bachelor of Science Degree in Pharmacy plus 1-3 years of relevant clinical experience
- Active State Pharmacy License
- At least 5 years practice experience or accredited Managed Care Residency
- Current knowledge and expertise in clinical pharmacology, disease management and managed care
- Experience with team-based care
- Self-management Skills – self-motivated, organized, detail oriented and manages time and resources effectively. Must be able to work independently in a collaborative environment, be self-directed and possess excellent organizational and time management skills
- Computer/Technology Competency: Proficient in use of Microsoft Word, Excel, and Outlook
Fully Remote:
This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence’s physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Vaccination Update
This job requires that you demonstrate you have been fully vaccinated for COVID-19 prior to the start of employment, to the extent permitted by law.
About Our Company
AmeriHealth Casualty has been successfully returning employees to work since 1994, providing quality medical treatment and care and reducing costs for our customers. With our affiliates, we serve more than 1,800 businesses in the area and have offices in Philadelphia, Camp Hill, and Pittsburgh, PA, and Mount Laurel, NJ.
In 1994, CompServices, Inc. began offering workers’ compensation third-party administration services for manufacturers, municipalities, health care facilities, social services, transportation risk, universities, and retail firms. In 1996, AmeriHealth Casualty Insurance Company was established as an extension of our workers’ compensation claims services — its mission to provide workers’ compensation insurance combined with high quality claims service and cost containment.
AmeriHealth Casualty Insurance Company and CompServices write premiums and administer self-insured programs for over 1,800 customers.
Equal Employment Opportunity
AmeriHealth Casualty is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Casualty employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Casualty and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Casualty or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.