Bilingual Pharmacist, Telehealth

Role Overview

• Conduct medication therapy management (MTM) and expanded clinical programs in accordance with the Centers for Medicare & Medicaid Services (CMS).
• Develop appropriate clinical algorithms, pathways, and call scripts to support pharmacy staff in delivering MTM services.
• Review and update all algorithms and call scripts at least yearly and with updated clinical guidelines.
• Develop documentation standards for all clinical outreach.
• Collaborate with other CEC staff to develop and maintain a high quality and consistent MTM product.
• Assist CEC leadership to develop programs to support STAR ratings outreach.
• Facilitate communication and education to clients, providers, and internal staff regarding MTM programs and program outcomes.
• Provide clinical outreach to members, prescribers, and pharmacy providers in order to enhance care coordination.
• Provide Medicare Part D clinical, operational and educational support by maintaining knowledge of all existing updates and regulations regarding the MTM program and Medicare Part C and D performance measures (STAR ratings).
• Stay current with new guidelines, literature, recommendations, and medications, and integrate that information into the MTM and STARs programs, such that our clinical outreaches remain up to date.
• Serve as a preceptor for APPE students within the CEC department.
• Maintain open lines of communication with other functional areas/departments.
• Develop a full understanding of Navitus Clients’ member experience and how the engagement center contributes to improved health and wellness.
• Adhere to compliance and HIPAA regulations.
• Other duties as assigned.

Requirements

• Pharm.D. degree with unrestricted licensure
• Minimum of two years clinical experience including direct consultation experience.
• Experience as a clinical call center lead is preferred.
• Experience as a member of a multi-disciplinary team is preferred.
• Professional PBM industry work experience is preferred.
• Knowledge of applicable data privacy practices and laws is preferred.
• Knowledge of healthcare industry practices and HIPAA regulations
• Spanish-speaking is preferred.
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5%
• No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!