Clinical Intervention Pharmacist Job Listing at Medical Mutual in OH (Job ID 2400536)

Description

Note, this is a fully remote opportunity in Ohio. 

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Develops strategies and engages members and/or providers to conduct clinically and financially meaningful interventions that impact member drug therapy. These interventions are aimed at improving pharmaceutical care for our members, reducing total cost of drug therapy, and improving pharmacy related quality measures such as Medicare STARS and HEDIS. Leads team in different projects and goals. Acts as new employee trainer and support for training of new initiatives and projects and as a resource for colleagues with less experience.

Responsibilities

·         Conducts targeted member and/or provider clinical interventions to ensure appropriate and cost-effective member drug therapy.

·         As assigned, addresses Medicare STAR drugs (STATIN, RASA, and non-insulin diabetes) adherence gaps.

·         Performs Consumer Assessment of Healthcare Providers and Systems (CAHPS)-focused interventions to improve drug plan perception.

·         May lead projects for existing staff and acts as a resource to newly hired staff, supporting management with training, assigned projects, and goals.

·         Develops strategies to engage members and/or providers and help drive improvements in pharmaceutical care and pharmacy quality measures to drive down drug spend.

·         Assists in closing Medicare STARS-related gaps by completing Comprehensive Medication Reviews (CMRs), Medication Reconciliation Post-Discharge (MRPs), and In-Home Assessments (IHAs).

·         Reviews drug/medical literature, clinical practice guidelines, quality measures, and available national guidelines to support drug therapy interventions and creation of new initiatives.

·         Develops written materials designed to enhance member adherence and other quality measures including appropriate use of medications and messaging campaigns. Provides internal professional staff and external provider education related to pharmacy drug therapy interventions.

·         Orients, trains, and assists new hires, residents, and junior level Pharmacists. Develops and maintains policies and procedures to support team as needed. Maintains and shares knowledge of prescription benefit trends.

·         Represents the department or division in activities or projects as assigned by management.

·         Performs other duties as assigned.

Qualifications

Education and Experience

·         Doctor of Pharmacy (Pharm.D.). In lieu of Pharm. D., may consider Bachelor of Pharmacy with relevant experience.

·         5 years of experience as a Clinical Pharmacist in a managed care pharmacy setting.

·         Medicare/Medicaid experience preferred.

Professional Certification(s)

·         Registered Pharmacist with current unrestricted license from the appropriate State Board of Pharmacy.

·         May be required to obtain Ohio State Board of Pharmacy license within 6 months of hire.

Technical Skills and Knowledge

·         Comprehensive understanding of managed care pharmacy, drug utilization management, population health, and quality programs.

·         Knowledge of medical/pharmacy terminology/coding and specialty drug management.

·         Strong clinical acumen and strategic analysis skills.

·         Advanced Microsoft Office skills; basic proficiency with Visio and/or Access.

·         Ability to work independently.

·         Strong project management skills.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.

At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.