Who we are
Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.
Our commitment is to:
· Strive to apply an equity
lens to all our work.
· Reduce health disparities.
· Become an anti-racist organization.
· Create an equitable
work environment.
About the Role
The clinical pharmacist will support pharmacy initiatives to ensure appropriate medication use, and State Contract, Cascade Select, and Medicare Part D compliance.
To be successful in this role, you:
- Have a current, unrestricted license, either as a Registered Pharmacist (RPh) with advanced clinical pharmacy training, or a Pharm D required.
- Have managed care or clinical residency with advanced clinical pharmacy training required.
- Have two (2) years of experience with drug information and managed care drug therapy, including drug utilization review, formulary development and academic detailing preferred.
Essential functions and Roles and Responsibilities:
- Performs clinical reviews for override requests and appeals.
- Serves as a drug expert who will provide clinical consultation to Community Health Plan of Washington internal and external customers.
- Performs clinical in-service to Community Health Plan of Washington internal or external customers as needed.
- Supports evidence-based pharmacy intervention programs.
- Develops provider and member communication materials.
- Monitors and audits activities performed by Community Health Plan of Washington’s pharmacy benefit manager to ensure compliance with regulatory, contractual and accreditation requirements.
- Develops policy and procedures for pharmacy benefit management.
- Monitors, identifies, and addresses potential fraud, waste and abuse activities related to pharmacy.
- Helps inform provider groups regarding adverse drug utilization trend to ensure appropriate medication use.
- Assists in monitoring guidance from CMS and implementing required processes to ensure Part D compliance.
- Serves as a point of contact for selected Community Health Plan of Washington’s delegated entities.
- Perform clinical review for Patient Review and Coordination program to ensure appropriate care coordination and patient safety.
- Exempt – Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards.
- Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.
Knowledge, Skills, and Abilities:
- Strong clinical skills and knowledge of formulary management and clinical program development.
- Ability to manage multiple, complex, concurrent projects.
- Strong analytical skills.
- Strong project coordination skills.
- Excellent written and verbal communication skills.
- Excellent organizational and planning skills.
- Ability to work as a team member as well as independently.
- Self-starting and highly self-motivated
- Strong PC operation skills that include but not limited to Word, Excel, Visio, Access and PowerPoint.
- Strong interpersonal skills.
As part of our hiring process, the following criteria must be met:
- Complete and successfully pass a criminal background check.
Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.
- Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
- Vaccination requirement (CHPW offers a process for medical or religious exemptions)
- Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.
Compensation and Benefits:
The position is FLSA Exempt and is not eligible for overtime. Based on market data, this position grade is 71 (see full range below) and has a 10% annual incentive target based on company, department, and individual performance goals.
CHPW offers the following benefits for Full and Part-time employees and their dependents:
- Medical, Prescription, Dental, and Vision
- Telehealth app
- Flexible Spending Accounts, Health Savings Accounts
- Basic Life AD&D, Short and Long-Term Disability
- Voluntary Life, Critical Care, and Long-Term Care Insurance
- 401(k) Retirement and generous employer match
- Employee Assistance Program and Mental Fitness app
- Financial Coaching, Identity Theft Protection
- Time off including PTO accrual starting at 17 days per year.
- 40 hours Community Service volunteer time
- 10 standard holidays, 2 floating holidays
- Compassion time off, jury duty
Sensory/Physical/Mental Requirements:
Sensory*:
- Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.
Physical*:
- Extended periods of sitting, computer use, talking and possibly standing
- Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion
- Frequent torso/back static position; occasional stooping, bending, and twisting.
- Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.
Mental:
- Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines.
Work Environment:
Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.