UPMC Health Plan logo
UPMC Health Plan

UPMC Health Plan is a rapidly growing health insurance company based in Pittsburgh, Pennsylvania. Owned by the award-winning University of Pittsburgh Medical Ce

Senior Clinical Pharmacy Specialist

Location

Pennsylvania

Posted

1 day ago

Salary

$51 - $87 / hour

Seniority

Entry Level

Professional Certificate

Job Description

Senior Clinical Pharmacy Specialist

UPMC Health Plan

Title: Senior Clinical Pharmacy Specialist (Remote- Must be licensed in PA! Location: Remote PA, United States Job ID: 7928940840 Status: Full-Time Regular/Temporary: Regular Shift: Day Job Work Arrangement: Remote Facility: UPMC Health Plan Department: PHARMACY SRVCS Union Position: No Salary Range: $ 51.48-87.36 USD Job Description: UPMC Health Plan has an exciting opportunity for a Senior Clinical Pharmacy Specialist in the Pharmacy Services department. This is a remote position working Monday through Friday daylight hours. Registration as a registered pharmacist (RPh, in the Commonwealth of Pennsylvania or eligibility for licensure by examination or reciprocity is required. The Senior Clinical Pharmacist must demonstrate multiple years of being a consistent, high-performing team member as measured by both volume and quality of work performed. In addition to consistent, exceptional performance, the Senior Pharmacist must have already demonstrated their initiative and ability to work independently. This role will have completed several stretch projects as outlined by their manager. The stretch projects, in addition to all new projects, would then be the ongoing responsibility of the Senior Pharmacist to manage. This may include but is not limited to, training other staff, actively participating and contributing solutions in strategic discussions, assisting with internal and external audits, and creating and assisting with workflow improvement and efficiency initiatives. Additionally, the Senior Clinical Pharmacist will assist in finding new clinical, quality, and efficiency improvements through the management of the Formulary, Prior Authorization, and other clinical programs. This role is responsible for the successful and satisfactory completion of additional projects that are beyond their day-to-day tasks. Responsibilities: - The Senior Clinical Pharmacist must demonstrate multiple years of being a consistent, high-performing team member as measured by both volume and quality of work performed. In addition to consistent, exceptional performance, the Senior Pharmacist must have already demonstrated their initiative and ability to work independently. This role will have completed several stretch projects as outlined by their manager. The stretch projects, in addition to all new projects, would then be the ongoing responsibility of the Senior Pharmacist to manage. This may include but is not limited to, training other staff, actively participating and contributing solutions in strategic discussions, assisting with internal and external audits, and creating and assisting with workflow improvement and efficiency initiatives. Additionally, the Senior Clinical Pharmacist will assist in finding new clinical, quality, and efficiency improvements through the management of the Formulary, Prior Authorization, and other clinical programs. This role is responsible for the successful and satisfactory completion of additional projects that are beyond their day-to-day tasks. - The Product Development Pharmacist is responsible for: Assisting with clinical management of the designated line of business (Commercial, Exchange, Medicare, Medicaid, Exchange, and/or CHIP from a pharmacy formulary and operational perspective and for understanding and complying with rules and regulations affecting the business. Develop and revise various formularies for each line of business including sending communications, training of identified departments, updating all brochures, updating appropriate websites, and submitting change forms. Review new drugs promptly and submit change forms as appropriate. Research adequately and be properly prepared for all P&T Committee meetings, ensuring all recommendations for both new drugs and new policies are appropriate and have been discussed with subject matter experts. Present these assignments succinctly and at a suitable pace and answer relevant questions. - Provide innovative ideas for new and existing clinical program development, utilization management, formulary management, provider education, and therapeutic substitution programs. Work with employer clients, account management, and sales in meetings as assigned to improve the understanding of the pharmacy benefit, as well as offering recommendations. Additional responsibilities for the Sr Pharmacist include: - Administrative Participate in meetings, committees, and work groups both internally and externally as assigned. Maintain a solid understanding of the requirements of the Pennsylvania Department of Health, DPW, CMS, and the National Committee for Quality Assurance, specifically as they relate to the expectations of pharmacy operations. Ensure compliance with regulatory and accreditation requirements of clinical functions. Communication Foster and maintain collaborative relationships with internal and external customers. Communicate pharmacy information as appropriate to members, employer groups, and providers. Develop communication materials to providers, including discussions regarding formulary changes/adherence, health education, medication compliance, and trend management. - Teaching and Education Mentor students and assist in precepting for the residency program if applicable. Assists in the training of pharmacy personnel. - Special Skills/Ability to Interact: Have the ability to function independently, but support team concept. Behavior denotes reliability as demonstrated by prompt attendance and timeliness in completing designated workload and follow-up. Conveys and maintains professional image while interacting with coworkers, providers, and clients. Honor client and patient confidentiality. Qualifications - Internal - Bachelor of Science Degree in Pharmacy, and/or Doctor of Pharmacy Degree (Pharm.D. from an accredited U.S. School of Pharmacy. - Experience in pharmacy benefit management, insurance, managed care preferred and be knowledgeable in therapeutic interventions and other cost containment programs. - One year of experience in a managed care pharmacy setting. - Effective communication skills, both written and oral. - Must have strong analytical ability and organizational skills. - Computer literacy for pharmacy programming, word processing, data management. - Assessment of job-related skills and competency will be reviewed annually via daily functioning, job-related documentation, department-based competency programs, and continuing education activities. Licensure, Certifications, and Clearances: Registration as a registered pharmacist (RPh, in home state. Continuing Education requirements met each bi-annual cycle for re-licensure, as evident by obtaining a minimum of 30 hours of continuing education every 2 years in structured pharmaceutical education as necessary by the state board.

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