Highmark Health
Pharmacist - Case and Disease Management (CMDM) - Remote
Highmark Health, Santa Fe, New Mexico, us, 87503
Company
Highmark Inc.
Job Summary This role is part of a product-line specific multidisciplinary team (MA, ACA, Commercial) to close gaps in care for high-risk members. Through the team, patients who have high-risk gaps related to medication therapy are transitioned to a Pharmacist for Case & Disease Management (CMDM). The incumbent researches and evaluates the patient, applying clinical judgement to provide recommendations for closing care gaps. Interaction with patients, caregivers, physicians, and pharmacists may occur during interventions.
Essential Responsibilities
Review gaps in care for high-risk patients as part of a multidisciplinary team and conduct research, including gathering claims data and reviewing clinical resources to evaluate each patient's situation and propose appropriate clinical recommendations.
Contact patients, caregivers, physicians, pharmacists, and other stakeholders to intervene on identified gaps of care using clinical judgement and discretion.
Perform other duties as assigned.
Education Required :
Bachelor's Degree in Pharmacy
Preferred :
Doctorate in Pharmacy
Substitutions
None
Experience Required
(can be reduced to 1-2 years with a clinical residency):
5-7 years in Pharmacy
3-5 years in Pharmacist - Utilization Management
3-5 years in Pharmacist - Medical Therapy Management
Preferred :
None
Licenses and Certifications Required :
Registered Pharmacist
Preferred :
None
Skills
Oral & Written Communication Skills
Telephone Skills
Problem Solving & Decision Making
Compliance
Collaborative Problem Solving
Language (Other than English) None
Travel Requirement 0% - 25%
Physical, Mental Demands and Working Conditions Position Type: Office-based.
Occasional travel from the office to various work sites or from site-to-site.
Lifting: 10 to 50 pounds (varies from constant to occasionally).
Pay Range Minimum $92,300.00
Pay Range Maximum $172,500.00
EEO Statement Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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Job Summary This role is part of a product-line specific multidisciplinary team (MA, ACA, Commercial) to close gaps in care for high-risk members. Through the team, patients who have high-risk gaps related to medication therapy are transitioned to a Pharmacist for Case & Disease Management (CMDM). The incumbent researches and evaluates the patient, applying clinical judgement to provide recommendations for closing care gaps. Interaction with patients, caregivers, physicians, and pharmacists may occur during interventions.
Essential Responsibilities
Review gaps in care for high-risk patients as part of a multidisciplinary team and conduct research, including gathering claims data and reviewing clinical resources to evaluate each patient's situation and propose appropriate clinical recommendations.
Contact patients, caregivers, physicians, pharmacists, and other stakeholders to intervene on identified gaps of care using clinical judgement and discretion.
Perform other duties as assigned.
Education Required :
Bachelor's Degree in Pharmacy
Preferred :
Doctorate in Pharmacy
Substitutions
None
Experience Required
(can be reduced to 1-2 years with a clinical residency):
5-7 years in Pharmacy
3-5 years in Pharmacist - Utilization Management
3-5 years in Pharmacist - Medical Therapy Management
Preferred :
None
Licenses and Certifications Required :
Registered Pharmacist
Preferred :
None
Skills
Oral & Written Communication Skills
Telephone Skills
Problem Solving & Decision Making
Compliance
Collaborative Problem Solving
Language (Other than English) None
Travel Requirement 0% - 25%
Physical, Mental Demands and Working Conditions Position Type: Office-based.
Occasional travel from the office to various work sites or from site-to-site.
Lifting: 10 to 50 pounds (varies from constant to occasionally).
Pay Range Minimum $92,300.00
Pay Range Maximum $172,500.00
EEO Statement Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
#J-18808-Ljbffr