Clinical Program Manager
Full Time - Regular
Roseburg, OR, US
Umpqua Health Alliance is a coordinated care organization that is committed to improving the health and well-being of our members and the community. This position will primarily support the Director of Clinical Pharmacy Services with Utilization Management (UM) review. This is a remote position with a variable shift that may include weekend and holiday coverage.
ESSENTIAL JOB RESPONSIBILITIES:
• Develop and manage the Medication Therapy Management Program including performing related activities such as medication reconciliation, provider and member education, and care coordination.
• Assist the Director of Pharmacy in Utilization Management (UM) review for medications covered by OHP. This includes review and clinical determination for prior authorization requests and appeals.
• As assigned by Director of Pharmacy, may assist in occasional weekend and holiday on-call clinical coverage.
• Participate as a member of the UHA Pharmacy and Therapeutics Committee, if invited and no conflicts of interests exists.
• Assist the Director of Pharmacy in preparing drug monographs and other materials for Pharmacy and Therapeutics Committee.
• Assist the Director of Pharmacy in developing clinical criteria related to the management of the prescription drug benefit.
• Assist the Director of Pharmacy in developing clinical criteria related to the management of certain medical injectables covered under the medical benefit.
• Participate as a member of the UHA Interdisciplinary Care Team and attend internal and community meetings as appropriate.
• Other duties as assigned.
• Required: PharmD-Doctorate of Pharmacy
• Current Oregon State Pharmacist Licensure.
• Pharmacy degree (Pharm.D. preferred) and experience working for a managed care plan or PBM.
• Prefer knowledge of the Oregon Health Plan and Medicare Part D regulatory requirements.
• Excellent time management skills, excellent organizational skills and attention to detail, and excellent verbal and written communication skills
• Ability to work effectively with minor supervision.
• Must be able to work in a fast-paced environment with daily work processing deadlines.
• MS Word - Intermediate, Excel, PowerPoint - Intermediate and Internet - Advanced.