Company: Carle Health
Posted on: January 24, 2023
The Clinical Pharmacist is responsible for support of the formulary
process, utilization management criteria development and
application, drug utilization review, Fraud Waste and Abuse, and
member and provider education. The Clinical Pharmacist analyzes
clinical data from multiple sources to assist in developing
pharmacotherapy recommendations that encompass population health,
quality management, and care management. The Clinical Pharmacist
provides direct patient care related to medication prescribing,
administration, and monitoring within a care team model and
provides clinical expertise to assist the care team in completion
of their duties. This individual also participates in focused
medication studies as applicable.
Doctorate Pharmacy or an RPh; three years of clinical experience in
lieu of Pharm.D.
CERTIFICATION & LICENSURE REQUIREMENTS
Licensed Pharmacist Illinois.Board certification in Ambulatory Care
or completion of an Ambulatory Care residency preferred.
Must possess critical thinking skills and be able to analyze and
solve complex problems. Ability to communicate clearly and
professionally with internal and external customers, including
other healthcare professionals. Ability to anticipate and take
corrective action in response to market changes, including but not
limited to, new to market therapies, pharmacy regulations, and
prescribing patterns. Ability to maintain a credible professional
image with physicians and other health care providers. Proficiency
with MS products including Excel, Word and Powerpoint.
- Performs utilization management reviews.
- Serves as drug information resource for other departments.
- Assists with creation and maintenance of administrative and
utilization management policies.
- Assists Compliance Department with identifying and
investigating potential fraudulent or inappropriate practices.
- Maintains current knowledge of and ensures compliance with
government and commercial regulations.
- Additional functions as needed including but not limited to PBM
reporting, review of fraud waste and abuse reports, and project
- Conduct medication reviews at the request of member, provider,
or Care Coordinator.
- Serve as a subject matter expert for various committee or
subcommittees requiring pharmacy knowledge.
- Perform provider and member outreach calls as needed to close
identified gaps in care.
We are an Equal Opportunity Employer and do not discriminate
against any employee or applicant for employment because of race,
color, sex, age, national origin, religion, sexual orientation,
gender identity, status as a veteran, and basis of disability or
any other federal, state or local protected class. Carle Health
participates in E-Verify and may provide the Social Security
Administration and, if necessary, the Department of Homeland
Security with information from each new employee's Form I-9 to
confirm work authorization. - For more information:
Effective September 20, 2021, the COVID 19 vaccine is required for
all new Carle Health team members. Requests for medical or
religious exemption will be permitted.
Keywords: Carle Health, Champaign , Clinical Pharmacist, Healthcare , Champaign, Illinois
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