- Licensed as a Pharmacist in the State of Wisconsin (or eligibility for WI pharmacist licensure that must be obtained within three months of hire).
- For positions with responsibility in an outpatient/ambulatory care based setting, board certification through the American College of Clinical Pharmacy (ACCP) in pharmacotherapy and/or ambulatory care is required within two years of employment.
- For positions with responsibility in an acute care/hospital based setting, board certification through the American College of Clinical Pharmacy in pharmacotherapy or other pharmacy specialty is required within five years of hire.
- Interpret clinical guideline criteria to make clinical prior authorization and appeal determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times.
- Perform peer-to-peer reviews with providers when requested.
- Provide support to call center team by responding to clinical and operational questions concerning member accounts in a fast paced, structured environment.
- Assist in the resolution of disputes, grievances, and complaints involving pharmacy program issues.
- Deliver MTM services, including but not limited to, Comprehensive Medication Reviews, Disease Specific Medication Reviews, and Targeted Interventions to assess appropriateness of all medications, to optimize medication therapy and to improve clinical outcomes.
- Assist with the development, enhancement, and maintenance of operational functions, policy and clinical support, and member and provider education.
- Effectively communicate issues and resolutions to members, pharmacies, providers, vendors, and appropriate internal stakeholders.
- Collaborates with other clinical personnel in the development and maintenance of clinical criteria necessity criteria through evaluation of available clinical evidence (e.g., FDA labeling, pivotal clinical trials, authoritative compendia, peer-reviewed literature). Participates in and supports the clinical committees (e.g. P&T, UM) as applicable.
- Performs other related projects and duties as assigned.
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SHP Clinical Pharmacy Specialist - Marshfield, United States - Marshfield Clinic
Description
Come work at a place where innovation and teamwork come together to support the most exciting missions in the worldJob Title:
SHP Clinical Pharmacy Specialist - Temporary Position from Mid-May to Mid-August (Remote or Hybrid Option)
Cost Center:
SHP-Pharmacy
Scheduled Weekly Hours:
40
Employee Type:
Temporary - Health Insurance Only (Fixed Term)
Work Shift:
Mon-Fri; 8:00 am - 5:00 pm (United States of America)
Job Description:
JOB SUMMARY
The Clinical Pharmacy Specialist works with physicians, staff, and committees to optimize the care of patients by providing and supporting drug use and evaluation processes, quality improvement and safety initiatives, and medication therapy education while embracing the philosophies of pharmaceutical care and comprehensive medication therapy management.
This position provides pharmacist expertise in the field of pharmacy informatics including a working knowledge of medical information systems and their design, development, and integration into clinical practice and drug policy.
The Clinical Pharmacy Specialist works in conjunction with pharmacy administration to identify, justify, develop, implement, evaluate, and refine clinical pharmacy services and educational programs for Marshfield Clinic Health System.
JOB QUALIFICATIONS
EDUCATION
For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.
Minimum Required:
Doctor of pharmacy degree from an accredited college or university of the United States for positions in an outpatient/ambulatory care setting or hospital based positions or Bachelor of Science from an accredited school of pharmacy AND board certification through the Board of Pharmaceutical Specialties.
Bachelor of Science from an accredited school of pharmacy for positions in a managed care setting.Preferred/Optional:
None
EXPERIENCE
Minimum Required:
Completion of an American Society of Health-System Pharmacists (ASHP) accredited residency.
Individuals who have not completed an ASHP accredited residency program will be considered based on the following:
Five years of practice experience for positions in an outpatient/ambulatory care setting; three years of hospital pharmacy experience and hospital pharmacy information system and order set development experience for hospital based positions; for individuals working in a managed care setting, no prior experience required.
Preferred/Optional:
Experience in a tertiary care hospital for hospital based positions.
CERTIFICATIONS/LICENSES
The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.
Minimum Required:
Preferred/Optional:
None
Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states:
Alabama
Alaska
Arkansas
Florida
Georgia
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Michigan
Minnesota
Mississippi
Missouri
Nebraska
North Carolina
North Dakota
Ohio
Oklahoma
South Carolina
South Dakota
Tennessee
Texas
Utah
West Virginia
Wisconsin
Wyoming
Marshfield Clinic Health System will not employ individuals living in states not listed above.
The remote or hybrid option is at Security Health Plan which is a managed care environment.
Specific Responsibilities:
At Marshfield Clinic Health System, we are fully committed to addressing health equity, diversity and inclusion for our employees and providers, our patients, and the communities we serve.
Exclusion From Federal Programs:
Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid.
This is a condition of employment.Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.
Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer.All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
