Pharmacist

• Determines the suitability of individual patients for home care.
• Collects and organizes all patient-specific information needed to determine the suitability of patients for home care.
• Assesses patients' suitability for home care in accordance with Option Care policies.
• Medical condition and prescribed medication therapy suitable for home care services and prognosis with clearly defined outcome goals.
• Designs, recommends, monitors and evaluates patient-specific pharmacy care plans for the pharmacotherapy of home care patients.
• When appropriate, makes suitable recommendations for modifications in the prescribed medication therapy or monitoring parameters for a home care patient.
• Collects and organizes patient-specific information needed to prevent, detect, and resolve medication-related problems and to make appropriate medication therapy recommendations.
• Appropriate monitoring parameters are identified for each patient.
• Completes nutritional assessment of patients and makes appropriate recommendation.
• Modifies the pharmacy care plans for home care patients based on evaluation of monitoring data and other pertinent patient-specific information.

Clinical Pharmacist

• This is an exciting opportunity to help shape the quality of health care in Florida.
• We are seeking to hire a Senior Pharmacist who desires to work to enhance the delivery of health care services through the Florida Medicaid Program.
• This position requires a candidate who is creative, flexible, innovative, and who will thrive in a fast-paced, team-based work environment.
• This position is responsible for maintaining knowledge of statutes and rules concerning the work-related programs/initiatives, including: Florida Statutes, Florida Administrative Code, U.S. Code of Federal Regulations, contract guidelines, provider handbooks, federal laws and regulations;
• Coordinating projects and quality-related programs; determining the fiscal and clinical impact of changes or proposed changes in practices and health service delivery;
• Producing analytical/statistical reports; coordinating research and evaluations of initiatives; composing and reviewing interoffice and external communications; coordinating the design and development of special reports prepared from data maintained by subcontractors and the Agency.
• Researching databases for evidence-based literature (outcome studies) to support policy recommendations.
• Identify and document the need for special studies and projects to provide information and data for policy and program development activities.
• Review and analyze state and federal audit reports, program evaluations, monitoring reports, provider and recipient correspondence and other materials to determine the need for new or improved programs or major policy revisions.
• Identify, develop and implement more effective methods for involving providers, recipients and other departmental staff in policy and procedure revisions for Medicaid Fee-for-service and Managed Care programs.
• Review major policy proposals with other department staff, the Drug Utilization Review Board, the Pharmacy and Therapeutic Committee, provider groups and associations as needed.
• Maintain knowledge of organizational, operational, and programmatic concepts and practices applied by public, private, and nonprofit agencies and organizations engaged in pharmacy services activities.
• Maintain pharmaceutical knowledge of evidence-based treatments for medical and mental health conditions.
• Maintain and apply professional expertise to the evaluation of medication best practice guidelines to improve health outcomes in the Medicaid population.
• Stay current with the scientific literature and provide clinical consultation to Agency staff as requested.
• Serve as the subject matter expert for reporting to Federal Agencies.
• Responsible for designing and maintaining clinical and operational oversight frameworks that evaluate pharmacy benefits compliance with state contractual requirements, preferred drug lists (PDLs), prior authorization (PA) criteria, utilization management standards, and applicable Medicaid policy.
• Utilizes encounter data, pharmacy claims data, MCO contracts, and MCO policies and procedures to identify trends, outliers, inappropriate utilization patterns and areas of financial or clinical risk requiring corrective action or escalation.

Senior Pharmacist

• Responsible for screening orders, specializing in research, review and entry of prescription overrides
• Ensure patients receive their correct prescriptions in a timely manner
• Direct questionable prescriptions to the prescriber for clarification
• Meet specified production and quality standards as defined by the management team
• Perform other pharmacy functions as required

Pharmacy Technician – Non Clinical Diverts

• Under the supervision of a licensed Pharmacist, assists with ensuring smooth and accurate pharmacy operations in accordance with Option Care Health policies & procedures, and the state's professional standards & regulations.
• Review/validate basic prescription drug refill requests and process according to OCH policies and procedures.
• Assists with preparing and dispensing medications & supplies.
• Assist with maintaining equipment through calibration, inspection, cleaning, testing, and informing supervisor of any defects.
• Collect & maintain basic patient information required to ensure accurate planning of needed materials/supplies, equipment, and prescriptions.
• Help ensure a positive patient experience through answering basic patient questions and responding to basic patient requests.
• Receives & verifies quantities of incoming supplies & materials.
• Stocks & stores new supplies & materials.
• Review expiration dates - Identifying shortages - Pick and pack materials & supplies.
• Create tickets - Tracking of inventory through accurate data entry into applicable system(s).
• Schedule routine patient deliveries.
• Clean & sanitize surfaces and laminar hood flows.
• Clean & organize supplies.

Clinical Pharmacy Technician II

• Collaborate with a high performing, multidisciplinary team of professionals across multiple functions to conduct comprehensive medication reviews (CMRs) for high-risk populations
• Conduct assessments of drug interactions
• Identify therapeutic duplications
• Evaluate renal and hepatic dosing adjustments
• Address evidence-based gaps in care
• Support STAR-related pharmacy initiatives
• Identify barriers to medication affordability and adherence

Clinical Pharmacist – MTM

• 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

• Perform care management activities for members with complex and chronic care needs
• Ensure high quality, cost-effective care and appropriateness of treatment
• Partner with physicians and/or pharmacists to interpret appropriateness of care
• Collaborate with providers to assess consumer needs and plan for adverse events
• Conduct clinical assessments to develop individual care plans and goals
• Monitor and evaluate effectiveness of care management plans

Clinical Nurse Coordinator – Telephonic

• assist in accurately reading, interpreting and entering prescriptions into the computer system
• calculation of doses and assignment of directions
• accepting proper insurance payment in a timely fashion
• routing incomplete or unclear prescriptions to the prescriber for clarification
• assist with inbound phone calls
• interact with customers and cross functional team to answer questions
• solve problems, provide education, and maintain high-quality service
• new patient enrollment and verification of insurance coverage
• perform benefit investigations and processing of medication orders for both new and existing patients

Pharmacy Care Technician

• Perform varied activities and moderately complex administrative/technical/operational/customer support assignments
• Manage daily worklists, conducting follow-ups, and prioritizing authorization requests
• Research and interpret insurance claims while using a broad array of clinical and informational resources
• Work directly with physician offices to initiate and complete prior authorization requests
• Ensure compliance with quality standards and departmental protocols
• Support the delivery of high-quality patient care and operational excellence

Specialty Pharmacy Technician, Prior Authorization

• Provide consultations through the patient's preferred method of communication (text, app messaging, email, or phone)• Perform initial assessments by gathering/reviewing chart notes to determine appropriateness of prescribing patterns• Perform clinical check-ins to monitor adherence, efficacy, adverse reactions, and drug interactions• Identify patients in need of clinical interventions and work collaboratively with providers to provide therapeutic recommendations resulting in improved patient outcomes• Ensure transition of care by transferring out prescriptions to appropriate pharmacies in situations where Alto is unable to fulfill a patient’s prescription• Being responsible for communicating prescription statuses to patients and providers• Work closely with Specialty Operations to provide quality care through the following:• Maintain an in-depth understanding of pharmacy billing including but not limited to Medicaid, Medicare, ADAP, commercial insurance, and foundation assistance programs to help troubleshoot patient cost barriers• Proactively identify and communicate areas of concern regarding scheduling/delivery procedures• Develop and provide drug information material designed to enhance Specialty Operations’ performance• Stay abreast of relevant and evolving regulatory and industry standards, ensure that appropriate action is initiated, and communicate these trends to applicable personnel• Work interactively with a local and/or dispersed team to achieve company business and compliance goals/objectives

Patient Care Pharmacist – Short Term Assignment

• Assists pharmacist with the preparation and dispensing of medications and supplies
• Prepares medications so they are accurately compounded
• Performs basic pharmaceutical calculations
• Accurately labels and packages medications
• Ensures pharmacy surfaces and laminar flow hoods are cleaned and sanitized
• Inspects equipment and documents any equipment failures or defects
• Assists with recording and maintaining pharmacy temperature & cleaning logs

Compounding Pharmacy Technician I

• Serve as a member of the central services team for pharmaceutical support.
• Ensure delivery of therapeutic medication monitoring and protocol management.
• Collaborate with Hematology/Oncology physicians and nursing staff to provide quality patient care.
• Coordinate the drug therapy process for Hematology/Oncology patients.
• Provide timely consultation services on new approved therapies.
• Review drug utilization reports and develop action plans for appropriate usage.
• Assess changes needed to improve care and pharmacy practices.
• Participate in quality assurance and continuous improvement strategies.
• Execute project activities in accordance with established schedules.

Clinical Oncology Pharmacist

• Provide Comprehensive Medication Management (CMM) in collaboration with hub-based and virtual clinical care teams and provide other pharmacist support services as needed.
• Contribute in the development of a medication management action plan to achieve member self-management goals and clinical outcomes, with measurable parameters and timeline for monitoring and follow-up.
• Communicate and work collaboratively with Cityblock and external providers belonging to member care team to ensure all clinical interventions and encounters are aligned with medication-related goals, and conduct ongoing assessments and refinements to care plan necessary to promote goal attainment.
• Provide direct support to clinical team members for all general drug information, dosing, interaction/adverse effect avoidance questions or member-specific needs.
• Participate in staff education through presentation of medication management in-services, development of educational tools for clinical and non-clinical team members, and training/coaching/facilitating all roles on consistent maintenance of a member’s best possible medication list care management platform, Commons, as well as post-discharge med reconciliation process for providers.
• Help develop medication management and disease state-specific clinical pathways/protocols, with the eventual goal of transitioning to collaborative practice agreements (CPA) with Cityblock physicians, permitting pharmacist to perform member assessments, order laboratory tests, and initiate or adjust medications per protocol to improve the efficiency and effectiveness of team-based care.

Ambulatory Care Clinical Pharmacist

• Review medication lists to eliminate barriers to therapy
• Contact pharmacies for medication refills
• Document care and communicate with providers
• Facilitate access to medications for financially challenged members

Clinical Pharmacy Technician

• Oversee dispensing of prescriptions
• Receiving physician prescription orders and evaluation for appropriate dosage, potential drug interactions, route of administration
• Supervise Pharmacy Technicians
• Communicate with physician offices, patients, and call center staff
• Provide patient counseling, education and monitoring for Rx products and exercise good pharmacy practice
• Special Projects as business needs require
• Perform other duties and responsibilities as assigned
• Data verification for prescription accuracy and compliance
• Outbound and inbound calls to providers for clarifications or additional clinical information
• Patient consults to address medication questions and provide guidance
• File adverse events and document appropriately per regulatory requirements

• Serve as an instructor and subject matter expert
• Offer specialized consultation to other business coaching team members
• Collaborate with assigned Business Coaching Coordinator
• Enhance customer retention and engagement
• Execute complex processes and engage in client-facing situations
• Continuously maintain and update coaching activities within the CRM system
• Compile pharmacy data to prepare necessary reports
• Drive results by aligning opportunities with customer needs
• Oversee all aspects of programs
• Identify potential weaknesses within pharmacy operations
• Work closely with Business Coaching Coordinator to assess customer needs
• Guide in-store implementations
• Develop and maintain a strong understanding of the independent retail pharmacy market
• Provide leadership with insights on industry intelligence
• Create and implement new concepts

Pharmacy Business Consultant

• 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

• Act as a subject matter expert on complex pharmacy issues
• Respond to escalated calls from members, provider/physician's offices, and pharmacies
• Make outbound calls and enter pharmacy overrides into systems
• Take member/prescriber/pharmacist inquiry calls for benefit questions
• Offer options including submission of prior authorization requests
• Research issues and take appropriate action to resolve them
• Conduct inbound and outbound calls for claims resolution
• Assist team members in guiding them to appropriate resolution of inquiries
• Participate in training less experienced staff
• Act as a liaison between internal departments for data gathering and problem solving
• Present proposed solutions clearly
• Assist with audit preparation and special project work as assigned
• Comply with all policies and standards

Senior Pharmacy Resolution Specialist

• Determines the suitability of individual patients for home care.
• Collects and organizes all patient-specific information needed to determine the suitability of patients for home care.
• Assesses patients' suitability for home care in accordance with Option Care policies.
• Designs, recommends, monitors and evaluates patient-specific pharmacy care plans for the pharmacotherapy of home care patients.
• When appropriate, makes suitable recommendations for modifications in the prescribed medication therapy or monitoring parameters for a home care patient.
• Provides medication-use education to Option Care staff, other professionals, home care patients and/or their caregivers.
• Ensures continuity of pharmaceutical care to and from the home and other patient-care settings.
• Prepares and dispenses medications using appropriate techniques and following Option Care policies and procedures.
• Adheres to appropriate safety and quality assurance practices.
• Maintains confidentiality of patient and proprietary information.

• Verifies member information and inputs data for the pharmacists
• Serves as mentor for less experienced staff
• Serves as department representative on intra-departmental initiatives
• Assists in formal training of associates and process improvement initiatives
• Conducts reviews by utilizing appropriate scripted algorithms in compliance with department guidelines
• Develops working partnerships with physicians and healthcare service providers
• Refers treatment plans to peer clinical reviewers in accordance with established criteria/guidelines

See all jobs on JobTailor

Clinical Pharmacist

Senior Pharmacist

Pharmacy Technician – Non Clinical Diverts

Clinical Pharmacy Technician II

Clinical Pharmacist – MTM

Senior Pharmacy Performance Specialist

Clinical Nurse Coordinator – Telephonic

Pharmacy Care Technician

Specialty Pharmacy Technician, Prior Authorization

Patient Care Pharmacist – Short Term Assignment

Compounding Pharmacy Technician I

Clinical Oncology Pharmacist

Ambulatory Care Clinical Pharmacist

Clinical Pharmacy Technician

Pharmacist

Pharmacy Business Consultant

Clinical Pharmacist – Medicare STARS

Senior Pharmacy Resolution Specialist

Clinical Pharmacist

Pharmacy Technician II, BioPlus Specialty Pharmacy