Wildomar, California
Gaylord, Michigan, Michigan
Posted: 27-Oct-24
Location: Dallas, Texas
Salary: Open
Categories:
Internal Number: 143910112
Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.?
The WellMed Quality Pharmacy Operations team supports WellMed Medical Management by delivering patient-centered, clinically collaborative medication consultations to help people live healthier lives. Our team focuses on the design, execution, and delivery of telephonic and digital engagement strategies designed to close STARs measure gaps in care, e.g. medication adherence, care for older adults, statins in patient with diabetes. Our interdisciplinary service delivery team is comprised of Pharmacists, Pharmacy Technicians, Licensed Vocational Nurses, and Care Coordinators.
The Clinical Pharmacist (CP) will report into the Director of Clinical Pharmacy. The Clinical Pharmacist will perform telephonic, patient-centered clinical consults focused on Care for Older Adults annual medication reviews, pain and functional assessments. In addition, the CP will act as a field consultant for providers and clinics via in-person and virtual meetings. The CP will be required to meet or exceed established productivity and quality metrics and work a flexible schedule to support the hours of operation of the business (Mon-Fri 7am-6pm Central and Saturday 8am-5:30pm Central).
This role will support West Texas and East Texas virtually, with 25 - 50% travel in the DFW Metroplex area.
Position in this function must hold an active, unrestricted Pharmacy License in the State of Texas.
Position in this function must must have Medicare STARs & HEDIS Measures experience.
Primary Responsibilities:
- Role will split time between telephonic patient outreach to complete assessment and provider facing activities (virtual and in-person) working with market representatives
- Develop market business plans to motivate providers and large or complex group leadership to engage in improving Stars measures to be 4 STARS or higher for pharmacy related measure for Statin Use in Patients with Diabetes, Statin Use in Patients with Cardiovascular Disease, Medication Adherence for Diabetes, Cholesterol and Hypertension
- Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups for pharmacy measures including information on best practices and addressing patient barriers
- Be the primary subject matter expert for all STARS related activities within their assigned market(s) working within a matrix relationship which includes Quality corporate operations and Regional/Market operations.
- Lead or participate and present in weekly, Monthly, Bi-monthly, Quarterly and/or Annual Business Review meetings related to STAR activities which summarize provider and large group performance and market performance as requested by or required by Quality or Regional leadership.
- Analyze and evaluate provider and large group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies
- Assist in developing of training and analytical materials for Stars and HEDIS
- Identify and assess decision makers and other key provider group personnel with a focus on identifying barriers to achieving targeted outcomes, focus communications and efforts accordingly
- Develop solution-based, user friendly initiatives to support practice success
- Place outbound calls to members to ascertain information from the patient regarding HEDIS and Quality measures related to their care as well as obtain member information regarding any possible gaps in care
- Complete annual medication review of prescription and non-prescription medications with emphasis on patient assessment and counseling, safe and effective use of medications, identification of potential drug interactions, and other related activities
- Complete pharmacotherapy assessment of patients' claims, past medical history, and disease states
- Assess patients for medication adherence barriers and develop a plan to maximize patients' medication success through improving or maintaining adherence to medications
- Deliver a patient-centered, clinically collaborative medication consultation
- Develop a post-consultation list of action items for the patient and/or prescriber
- Maintain a high level of clinical knowledge of chronic disease states and changes in pharmacy practice in adult and geriatric patient populations to serve as an authoritative information source on drugs and their utilization in therapy
- Performs all other related duties as assigned
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Doctor of Pharmacy degree or Equivalent Experience
- Must hold an active, unrestricted pharmacy license in the state of Texas
- 5+ years Clinical Pharmacy Practice experience
- 2+ years experience with Medicare STARs & HEDIS Measures
- 2+ years of experience in provider facing interactions, including provider education
- 2+ years of experience with data analysis and/or quality chart reviews. Must be able to review data and provide recommendations for improvement
- 1+ years Call Center Experience
- Proficient with Microsoft Word, Excel, Outlook, PowerPoint
- Comfortable working in a rapidly changing and highly matrixed environment
- Located or within driving distance of market being supported
Preferred Qualifications:
- MBA/MPH Degree
- Post Graduate Training (Pharmacy Residency and/or Fellowship)
- Board certification by the Board of Pharmacy Specialties (BPS)
- Certified Geriatric Pharmacist
- Bilingual preferred with preference given to Spanish
- Proven excellent written and verbal communication and relationship building skills
- Proven planning and organizational skills to demonstrate leadership and initiative
- Proven solid interpersonal skills
- Proven ability to manage multiple complex, concurrent projects
- Proven ability to work independently, as well as a member of a team
Physical & Mental Requirements:
- Ability to lift up to 25 pounds
- Ability to sit for extended periods of time
- Ability to use fine motor skills to operate office equipment and/or machinery
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
- Ability to operate motor vehicles and drive distance of 100+ miles per day
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
