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Medicaid Clinical Pharmacist - Growing Health Plan

Company: Fallon Health
Location: Worcester
Posted on: April 17, 2018

Job Description:


Provides clinical pharmacy support to Medicaid ACO and MCO members by:

* Identifying members for interactive consultation based on risk stratification or predictive modeling

* Performing medication reviews to identify medication related problems

* Performing interactive consultations and making recommendations/interventions for members and providers, appropriately documents all pharmacotherapy interventions in internal case management tracking system

* Interacting with members telephonically or in person to review and reconcile medications

* Providing medication education telephonically or in-person to members

* Communicating trends identified from medication reviews to prescribers and/or clinical team members

* Receiving and responding to escalated calls regarding clinical or medication procurement issues

* Researching and resolving provider clinical inquiries in regards to medication and disease state management

* Designing and implementing targeted medication and disease management programs by analyzing medical and pharmacy utilization reports

* Designing and implementing targeted medication and disease management programs to ensure compliance with CMS and EOHHS requirements and regulations

* Providing in-service education related to medications, pharmacy or quality initiatives. In-services may be designed for internal or external audiences including members.

* Assisting in implementation of new disease or medication management programs

* Coordinating with internal departments and external clients on disease and/or medication management projects.

* Reporting on clinical and financial outcomes of programs

* Providing pharmacy clinical services and programs designed to coordinate with community health center and community based pharmacies

* Provide required data and clinical reports for compliance and audits





Current License to practice as pharmacist in Massachusetts without restriction.


5 years with at least one year in a managed care environment

1-2 years professional experience practicing as a clinical pharmacist

Keywords: Fallon Health, Worcester, Medicaid Clinical Pharmacist - Growing Health Plan, Healthcare, Worcester, Massachusetts

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