Pharmacist

• Acts as a liaison between Finance, Analytics, IT and Pharmacy
• Focus on understanding data content and the business logic behind all data transformation for reporting
• Develop expertise in the data and systems leveraged internally and externally for the Pharmacy Department
• Gather requirements, perform analysis, support the development and testing of processes
• Understand and document the applications, data and associated technologies for the Pharmacy Department

Senior Pharmacy Performance Specialist

• Demonstrates comprehensive knowledge of current pharmacotherapeutic principles, medical terminology, pathologies, disease state and population management, age appropriate therapy, and other information as related to medical and/or pharmaceutical care management.
• Work with Sentara Health Plan (SHP) members to close medication-related gaps in care
• Work on the referrals from the team
• Counseling members on their medication therapy

Clinical Pharmacist – Medicare STARS

• Support the pharmacy team in delivering operational and service excellence within your store
• Assist the pharmacy team to ensure that pharmacy operations run smoothly, our patients’ prescriptions are filled promptly, safely, and accurately
• Provide caring service that exceeds patient expectations
• Operate as part of the pharmacy team through consistent application of Standard Operating Procedures (SOPs), best practices, and effective communication
• Complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s Board of Pharmacy guidelines
• Comply with CVS policies and procedures to ensure patient safety, compliance with controlled substance dispensing and recordkeeping, and to protect patient privacy and security
• Complete additional patient health care services (e.g., immunizations, point-of-care testing, and voluntarily staffing offsite clinics) where allowable by law and supported by required training and certification

Pharmacy Technician

• Support the pharmacy team in delivering operational and service excellence within your store
• Assist the pharmacy team to ensure that pharmacy operations run smoothly
• Deliver an exceptional experience to patients and customers
• Complete basic inventory activities as permitted by law and directed by the pharmacy leadership team
• Assist with immunizations and track patient information where permissible

• Review and render decisions on authorizations and appeals for specialty, non-specialty, and physician administered drugs
• Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations
• Participate in clinical quality audits and inter-rater reliability testing
• Provide internal team support for escalations and questions
• Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals by members and providers.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Prior Authorization Pharmacist

• Use Oscar and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests
• Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information
• Collect relevant medical information (via telephone, fax, and portal) and apply the appropriate PA criteria, clearly documenting all communication and decision making
• Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review
• Communicate oral and written prior authorization outcome notifications that comply with standards and requirements for content and accuracy
• Compliance with all applicable laws and regulations
• Other duties as assigned

Prior Authorization Pharmacy Technician

• Optimize patient outcomes through telephonic interventions
• Focus on the tactical execution of medication management services, including polypharmacy, adherence, and pharmacotherapy optimization
• Counsel patients via telephonic outreach on medication adherence, address any medication related problems such as adherence barriers, polypharmacy, or high risk medication use, and make appropriate evidence-based recommendations to patients and Practice Care Teams
• Perform focused clinical chart reviews as needed to inform patient interventions
• Obtain and document patient commitment to medication adherence and address barriers in real time
• Escalate complex clinical cases to prescribers or interdisciplinary teams as appropriate
• Meet and sustain performance goals (e.g., STARs, HEDIS)
• Collaborate with Physicians, clinical and administrative staff to optimize the Medication Management workflow and patient experience
• Proactively identify gaps in medication management through patient interactions and translate patient insights into targeted recommendations that drive improvements in practice operations and clinical workflows
• Participate in the design, implementation, and evaluation of pilot programs or process changes (“test and learn”) within the outreach model
• Serve as a clinical subject matter expert, leveraging clinical pharmacy expertise to support organizational objectives and adapt to evolving healthcare needs
• Develop and maintain standardized resources, educational tools, and clinical protocols to support improved medication outcomes and performance on quality measures (e.g., STARS, HEDIS) for practices, clinicians, and patients

See all jobs on JobTailor

Senior Pharmacy Performance Specialist

Clinical Pharmacist – Medicare STARS

Pharmacy Technician

Pharmacy Technician

Prior Authorization Pharmacist

Prior Authorization Pharmacy Technician

Clinical Pharmacist, Pharmacy Outreach