Job Summary
Provides support and subject matter expertise for clinical pediatric pharmacy services and support. Contributes to overarching clinical pediatric pharmacy strategy for optimization of clinical and medication-related health care outcomes, and quality cost-effective member care.
Essential Job Duties
• Provides clinical pediatric rounds support including examination of member medical records, comprehensive medication reviews, and communication with Health Care Services leadership and nurse case managers who provide outbound support to members and providers
• Support clinical case referrals from Health Care Services/nurse case managers through reviews of member medication profiles and applyingevidence-based medicine and national guidelines when creating recommendations for health care providers for optimization of member medication regimens.
• Analyzes and reviews medication lists for potential patient safety issues, including drug interactions, suboptimal medication regimens, etc in both clinical pediatric rounds and clinical case referral support.
• Promotes clinically appropriate prescribing practices based on evidence-based medicine and national guidelines through various modalities (provider/plan profiling, member drug profile reviews, medication protocols/criteria, and case-by-case interventions).
• Conducts training as needed to Health Care Services leadership/nurse case managers on self-serve pharmacy resources (formulary lookup, pharmacy locator, etc) as well as articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed.
• Researches, develops, and implements drug utilization and disease state management strategies and intervention techniques to deliver high quality, cost effective health care.
• Assists Health Care services leadership and nurse case managers in coordination of care for pharmacy-related issues as nurse case managers provide the necessary outbound health plan service support to members, their caregivers, and providers.
• Serves as a pediatric drug information resource to pharmacy staff, Health Plan Chief Medical Officer, and Health Plan Health Care Services/nurse case manager staff
• Reviews and analyzes clinical reports generated internally or through external Pharmacy Benefit Manager (PBM) to track general clinical trends in drug utilization and identify potential clinical trend issues to be addressed
• Works with Healthcare Services team (e.g., data managers, care managers, etc.) on member-centered interdisciplinary teams.
• Assists leadership in developing/updating policies and procedures, and implementing changes to comply with state and federal regulations.
Required Qualifications
• Doctor of Pharmacy (PharmD). Resident of Florida with active Florida License must be active and unrestricted in applicable state(s) of practice.
• Demonstrated knowledge and expertise in clinical pharmacology and disease management for pediatric populations.
• Clinical skills related to pediatric pharmacy And demonstrated knowledge of best practices in clinical pediatric-related disease states.
• Current knowledge and expertise in clinical pharmacology and disease management.
• Ability to present ideas and information concisely to varied audiences.
• Knowledge of processes and systems, and ability to develop and deliver necessary training to departmental staff and internal customers.
• Ability to develops and maintain positive and effective work relationships with coworkers, members, providers, regulatory agencies and vendors.
• Proficiency in compiling data, creating reports and presenting information.
• Ability to meet established deadlines.
• Functions independently and manages multiple projects.
• Excellent verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
Preferred Qualifications
• At least 3 years of experience in a Managed Care Pharmacy, Pharmacy Benefit Manager (PBM), or related healthcare organization (ie hospital, ambulatory care, etc) experience.
• Pediatric Pharmacy Specialty Certification (BCPPS®)
• Completion of a PGY1 residency plus two (2) additional years of post-licensure practice
• Completion of a specialty (PGY2) residency in pediatric pharmacy
• Medicaid experience
• Clinical skills or pharmacotherapy expertise for clinical pediatric-related conditions and medications.
• Experience with team-based care.
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To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $80,412 - $156,803.45 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
