Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Clinical Programs Pharmacist.
Primary Responsibilities:
- Under the direction of the Senior Vice President for Population Health and Chief Medical Officer, provides clinical pharmacy direction for the company’s programs including, but not limited to Population Health, Disease Management, Pharmacy, Utilization and Quality Management.
- Assists management in identifying program needs for identifying high risk members based on pharmacy and medical claims for specific member interventions.
- Maintains drug lists to support the specification writing and programming for health outcomes measures reporting, including, but not limited to: drugs to treat hepatitis C, HIV, sickle cell disease and substance abuse, as well as opioids, specialty drugs, and drugs used for prenatal and maternal care and family planning.
- Serves as a resource for drug information throughout the organization, including HEDIS program manager and abstractors, medical economics analysts, and case management.
- Implements the pharmacy related requirements of CHNCT’s contract with the Department of Social Services.
- Assists with the development, presentation, and implementation of policies and procedures consistent with the regulatory requirements of the contract.
- Oversees pharmacy utilization and identifies trends.
Tasks Performed:
- Works directly with the Chief Medical Officer along with the VP of Medical Economics and Quality Management and IT to develop 'best in class pharmacy reporting to assist in monitoring and reporting of pharmacy information to senior management and DSS.
- Updates existing drug lists (NCD codes) on a monthly basis to support health outcomes measures reporting. Creates new drug lists to support new programs as added.
- May assist in DUR’s on high-risk members as identified by ICM.
- Works with existing subscription to national drug databases and an IS programmer to identify or develop software to identify high risk members through a combination of pharmacy and medical claims as well as a pharmacy risk score.
Essential Functions:
- Reviews prescribing practices of high utilizing physicians and intervenes as needed, providing drug information on pharmacy expenses.
- Recommends changes in prescribing practices to improve quality and lower costs.
- Provides detailed claim analysis for over and underutilization.
- Provides clinical pharmacy support for Care and Disease Management programs, Quality and Utilization Management with an emphasis on high-risk conditions.
- Continues to monitor literature for new and emerging therapies for impact on the program, including introduction of high-cost medications
- Performs special duties as needed.
Desired Education: 7+ years post-secondary schooling
Desired Degree: Doctor of Pharmacy degree from an accredited institution. Pharmacy license must be current and unrestricted
Desired Major: Pharmacy
Desired Job Experience: 7+ years’ related experience in health plan pharmacy and pharmacy benefits management. Strong clinical knowledge and skills. Superior interpersonal skills; ability to motivate those within the department and at all levels of the organization toward common goals and deadlines. Ability to build relationships and interact with external constituencies (especially DSS and vendors such as the HEDIS vendor, MediSpan, etc.). Strong familiarity with contemporary database applications and their use in managing health data. Strong working knowledge of the Microsoft Office Suite particularly Excel, and Word. Superior organizational skills and detail orientation.
Other Qualifications: Proven leadership skills and ability to build effective teams and direct the management of multiple, complex, high impact projects from planning to monitoring to implementing provider interventions and reporting results. Effective oral and written skills; able to prepare presentation materials, format and content to the needs of target audiences.
Certifications Required: Registered Pharmacist. Pharmacy license must be current and unrestricted
CHNCT Offers Great Benefits:
- Medical, dental and vision coverage options
- Flexible spending and health savings accounts
- Group term life insurance
- A 401(k) plan with company-match and immediate vesting
- Voluntary accidental injury coverage
- Tuition reimbursement and continuing education opportunities
- A generous paid-leave bank and company holidays
- Wellness program
CHNCT is an equal opportunity, affirmative action employer m/f/d/v and proud of the diversity of our workforce.
Important Note to Applicants: CHNCT as a company feels very strongly that we need to do what we can to help control the spread of COVID-19 infections. Therefore, all employees, contractors, consultants and agency temporary staff are required to be fully vaccinated to work at CHNCT. Reasonable accommodations for medical or religious exemptions will be provided with appropriate documentation for positions that do not have in-person/member visitation requirements.