Population Health Clinical Pharmacist NE

Primary City/State

Mesa, Arizona

Department Name

Banner Staffing Services-AZ

Work Shift

Day

Job Category

Pharmacy

Job Summary

Pharmacy careers are better at Banner Health. We are committed to developing the careers of our team members. We care about you, your career today and your future. If you’re looking to leverage your abilities - apply today.

Position Overview

As a Population Health Clinical Pharmacist, you will support value based care work and be able to effectively communicate with patients and providers. You will collaborate with the healthcare team to identify and address pharmacy related Stars measures and assist with pharmacy initiatives related to cost savings and improved patient care. You will also oversee daily activities of pharmacy technicians. Population health work experience with focus on value based care and managed care will be helpful in this role. There may be a request for you to pursue CO licensure to assist with any additional books of business that may expand to that area in the future. No current deadline set.

The schedule for this position varies, you can anticipate at least once a week staffing during the weekdays, and may need additional coverage for staff absence, weekend overlap (Saturdays), and for other business needs.

Benefits & Perks

• Competitive wages
• Paid orientation
• Flexible Schedules (select positions)
• Fewer Shifts Cancelled
• Weekly pay
• 403(b) Pre-tax retirement
• Employee Assistance Program
• Employee wellness program
• Discount Entertainment tickets
• Restaurant/Shopping discounts
• Auto Purchase Plan

Note About Registry/Per Diem Positions

Registry/Per Diem positions do not have guaranteed hours and no medical benefits package is offered. Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education) is required.

Position Summary

This position supports all aspects of pharmacy services within the Banner Health Insurance Division, including utilization management, care management, and pharmacy quality responsibilities. This position drives optimal member experience, provider experience, and financial performance through assigned areas of work. Incumbents maintain a high degree of clinical acumen, and leverages strong organizational, communication, and execution skills to ensure the successful deployment of pharmacy benefits across all populations. This role is highly independent, and incumbents work across departments, and with internal and external stakeholders.

Core Functions

1. Provides management of pharmacy services to Insurance Division members, including commercial, Medicare, Medicaid populations within owned/operated health plans as well as value‑based agreements. Identifies and stratifies members based on complex pharmaceutical care needs to optimize pharmacotherapy regimens at the patient/member level, and population level to improve overall healthcare quality and reduce costs that is consistent with acceptable standards of pharmacy practice and CMS Medicare Part D regulations and guidance. Analyzes and interprets pharmacy and medical claims reporting and other sources of clinical and economic data to generate insights and clinical service opportunities.
2. Active participant and/or leader in defining, implementing, and managing clinical programs and services that improve pharmaceutical care quality and lowers costs in all Insurance Division lines of business. Programs include but are not limited to, medication therapy management, pharmacy quality measure performance, utilization management, member outreach and engagement, provider education and detailing, drug utilization reviews, or formulary monograph development.
3. Maintains proficiency in all legal, regulatory, and practice standards related to CMS, AHCCCS, or out‑of‑state Medicaid programs. Maintains proficiency in all pharmacy related URAC, NCQA, or other applicable accreditation standards. Maintains clinical proficiency in assigned clinical area(s) through continuing education.
4. Conducts utilization management reviews and adjudicates prior authorization requests and appeals. Participates in multidisciplinary appeals and grievances reviews as assigned. Takes ownership to identify and resolve utilization management issues and promotes a best‑in‑class member and provider experience and optimal clinical outcomes for the member.
5. Communicates with and supports Insurance Division members and network providers and support staff, Health Plan leaders, and Insurance Division executives concerning pharmacy issues and programs and services. Works closely with phar