You Make Us Grow. You Make Us Sharp.

Hours:

Shift Start Time:

8 AM

Shift End Time:

5 PM

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

Not Specified

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$27.840 - $34.800 - $41.770

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do
To gather, review, and analyze all pertinent information for appropriate medication therapy management initiatives. Create and disseminate recommendations and action plans per protocols. To assist in the day-to-day operations of the Medication Therapy Management division within the Ambulatory Case Management for all SCMG regions.

Required Qualifications

• H.S. Diploma or Equivalent
• 3 Years experience in a variety of patient care settings or pharmacy settings.
• California Pharmacy Technician License (TCH) - CA State Board of Pharmacy -REQUIRED

Preferred Qualifications

• experience in HMO or delegated risk medical group/IPA setting.
• experience with Electronic Health Records (EHR).
• Certified Pharmacy Technician (CPhT) - Pharmacy Technician Certification Board -PREFERRED

Essential Functions

• Develop and implement
  
  Develops, implements, and monitors various program Initiatives. Creates adjustments to process as necessary.
  Creates Desktop policies to define processes necessary for MTM initiatives and programs. Completes annual review and revision of MTM Desktop Policies.
  Keeps current knowledge and understanding of applicable accreditation and regulatory statutes related to health care, managed care and pharmacy practices.
  Maintain individual in-service and performance records.
  Attends and actively participates in department, team process, and quality improvement activities.
  Identifies areas of improvement where systems modifications could result in operational advancements and efficiencies.
  Participates in designing, developing, and implementing pharmacy clinical programs (via Lean Six Sigma or Continuous Quality Improvement projects) to promote quality, cost-effective pharmacy benefits for patients
  
• Program participation
  
  Completes the process within the required time frames. Develops process, monitors, and participates in MTM Initiatives.
  Creates and analyzes regular reports from MTM initiatives and programs. Prepares and presents reports to SCMG leadership and SCMG providers as necessary.
  Develops trending and analysis of reports of pharmacy metrics from SCMG database, and Health Plan data reports. Discusses strategies for further intervention targeting identified gaps.
  Acts as liaison between Pharmacists and PCP’s and Specialists. Attends Provider meetings as necessary.
  Travel to individual provider offices and other locations for meetings is required.
  
• Quality improvement
  
  Participates in quality improvement activities for the team and the department.
  Completes projects assigned by supervisor.
  Consistently participates in cost savings measures across the continuum of care (e.g. quality metrics)
  
• Daily Operations
  
  Under direct supervision of pharmacist, manages medication refill requests accurately and efficiently according to authorized protocols and collaborative agreement
  Conducts data collection, outreach, and initial review of all medications currently being prescribed/taken by referred patients and patients identified through initiative reports. Reviews may include but it is not limited to identification of medication related problems, adherence barriers, assistance in drug cost or prior authorization, and other related activities.
  Provides initial information and recommendations for MTM pharmacist on medication changes that would result in lower member copayments, and/or fewer medications taken per day for the member.
  Applies the principles of standard medical care and cost containment to all decisions. Maintains set turnaround times for program completion (subject to audit).
  Observes and follows through on Pharmacist or Medical Director directions in research and resolution of all cases and initiatives. Prepares referrals to MTM for Pharmacist, per Desktop policies.
  Completes research on medication related topics as requested by Pharmacist.
  Provides back-up support to MTM Care Coordinator.
  Observes Sharp Community Medical Group (SCMG) policies and procedures.
  

Knowledge, Skills, and Abilities

• Proficient in the use of business software programs including; MS Word, Excel, Access and IDX.
• Excellent organizational and time management skills, excellent analytical and problem solving skills.
• Excellent verbal and written communication skills.
• Ability to read, speak, and hear English clearly.
• Excellent knowledge and use of Medical Terminology.
• This position requires a thorough understanding of the functions of Managed Care including HMO/PPO and ACO eligibility, claims, utilization management and the financial impact of decisions related to each.
• Ability to research, investigate and identify medications taken by medical group enrollees through the use of multiple sources of information and determine health plan formulary coverage, member copayment, refill rates, compliance levels and availability of potential medication assistance programs.
• Ability to work independently in research and data collection functions with minimal direction from higher level staff.
• Ability to take incoming communications and thoroughly research each patients medication profile and history, including group data base analysis, contacting case managers, physician offices, pharmacies, health plan, hospitals and others as potential information sources.
• Ability to obtain pertinent information from physicians and patients and verify said information with health plans or other providers. Ability to make initial medication change recommendations to the MTM pharmacist based upon information gathered ensuring the best possible care for the member and a positive financial impact for the medical group.
• Ability to communicate medication refills and new prescriptions to network pharmacies as an agent of the prescriber as outlined under protocol.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

Certified Pharmacy Technician (CPhT) - Pharmacy Technician Certification Board; California Pharmacy Technician License (TCH) - CA State Board of Pharmacy; H.S. Diploma or Equivalent