JOB SUMMARY:The Clinical Pharmacist - Population Health supports Population Health Management (PHM) and Case Management by optimizing medication safety, effectiveness, adherence, and affordability. Working with members, providers, and interdisciplinary teams, this role conducts medication reviews, supports chronic condition management and care transitions, oversees PHM opioid safety initiatives, and provides pharmacy leadership for high-risk member care.
KEY RESPONSIBILITIES:- Conduct medication reviews to identify safety concerns, interactions, duplication, adherence barriers, and opportunities to optimize therapy.
- Recommend evidence-based medication interventions to providers and document recommendations, follow-up actions, and outcomes.
- Reconcile medications following hospitalizations and care transitions.
- Participate in interdisciplinary care planning and patient-at-risk committees to support safe, effective, and coordinated medication management.
- Educate members and caregivers on medication use, adherence, safety, and potential side effects while identifying and addressing access and affordability barriers.
- Oversee the PHM opioid safety program and maintain the high-risk medication list.
- Perform comprehensive, patient-specific clinical reviews of specialty and high-cost medications, considering diagnosis, patient weight, prior therapies, laboratory values, disease severity, treatment history, and other relevant clinical factors.
- Review patient-specific dosing and treatment regimens to promote appropriate therapy, improve clinical outcomes, and minimize medication waste.
- Identify safe, clinically appropriate, and cost-effective therapeutic alternatives, including preferred products, biosimilars, alternative dosing strategies, and other treatment options.
- Collaborate with behavioral health staff and other clinicians to support complex medication needs and chronic condition management.
- Support Pharmacy Case Management through comprehensive and targeted medication reviews.
- Collaborate with Pharmacy and Utilization Management teams to identify and resolve coverage, formulary, and other medication access barriers.
- Develop and maintain pharmacy workflows, clinical guidance, educational materials, and staff training to support consistent and effective medication management.
- Monitor pharmacy intervention outcomes, medication utilization, and cost trends; identify opportunities for improvement and support quality improvement, accreditation, and regulatory readiness.
- Maintain accurate and timely clinical documentation.
- Perform other job-related duties as required or assigned.
QUALIFICATIONS:- Strong knowledge of clinical pharmacy, managed care, population health, chronic conditions, and medication safety.
- Understanding of Medicare Advantage, Part D, Commercial plans, and pharmacy benefit operations; DSNP knowledge preferred.
- Ability to evaluate complex medication regimens and recommend evidence-based, cost-conscious interventions.
- Strong analytical, organizational, clinical decision-making, communication, and collaboration skills.
- Demonstrated ability to apply clinical judgment and evidence-based practices to medication management and patient-specific therapeutic decisions.
- Commitment to member-centered care and improving medication safety, effectiveness, access, and affordability.
- Proficiency with Microsoft Office applications, pharmacy systems, and electronic care management platforms.
- Remote work may be available to qualified candidates.
- Successful completion of Health Care Sanctions background check.
EDUCATION/EXPERIENCE:- Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy from an accredited School of Pharmacy.
- Active, unrestricted pharmacist license in the State of Oklahoma, or ability and willingness to obtain Oklahoma pharmacist licensure within 180 days of hire; duties requiring licensure begin after obtainment.
- Minimum of five years of clinical pharmacy experience in managed care, population health, ambulatory care, hospital pharmacy, medication therapy management, or a related setting.
- Experience with complex medication management, interdisciplinary care, Medicare Advantage/DSNP, transitions of care, opioid safety, or pharmacy quality improvement preferred.
- Pharmacy residency or relevant board certification preferred.
