Reports to the VP, Total Reward Strategy/Agility. To assess needs and implement cost effective alternative plans of care to positively impact the quality of life and clinical outcomes of individuals suffering from chronic conditions such as asthma, depression, diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and/or metabolic syndrome.
MISSION, VALUES and SERVICE GOALS
- MISSION: We deliver outstanding care, inspire health, and connect with heart.
- VALUES: Trust. Respect. Integrity. Compassion.
- SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
Serves as the Disease Manager, under a Collaborative Medical Director Agreement, for individuals covered by the Beacon Health System medical plan. Responsibilities include:
- Identifying high and medium risk members who may benefit from counseling. Using predictive modeling tools and real-time data to perform comprehensive disease management outreach with goal of increasing members' abilities to manage their chronic and acute health conditions and decrease unnecessary utilization.
- Analyzing data and assist with the process of monitoring clinical program effectiveness.
- Facilitating communication with members and care team, coordinate referrals, and promote optimal allocation of available resources.
- Adhering to evidence-based treatment guidelines in facilitating care for chronic care/disease management. Documents individualized care plans focusing on specific treatment goals and assesses progress towards goals based on clinical judgement and data.
- Assessing and monitoring adherence to outreach and problem-solving intrinsic barriers to effective member self-management of chronic conditions (education level, language, etc.).
- Identifying extrinsic barriers to adherence (transportation, financial constraint, pharmacy coverage) and works with member care team and other available resources to alleviate barriers.
- Informing members of how the counseling program works and communicating appropriate incentive programs.
- Scheduling and conducting intensive wellness care management visits which may include POC testing A1C, POC testing lipids, blood pressure, lab reviews, medication reviews and recommendations
Under the direction of best practice protocol and coordination with patient's physician, participates in drug regimen management and performs clinical services by:
- Changing the duration of treatment for a current drug therapy.
- Adjusting the strength, dosage form, frequency of administration or route of administration of a drug.
- Discontinuing the use of a drug.
- Adding a drug to the treatment regimen.
- Recommending, ordering and monitoring laboratory tests.
Serves as a resource to the Medical Staff and other healthcare professionals concerning pharmaceutical care by:
- Providing drug information services.
- Reviewing patient medical records and making recommendations about appropriate drug therapy.
- Identifying problems and making recommendations concerning member compliance, therapeutic response, drug interactions and similar issues.
- Collecting and analyzing data.
Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:
- Completing other job-related duties and projects as directed.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
- Attends and participates in department meetings and is accountable for all information shared.
- Completes mandatory education, annual competencies and department specific education within established timeframes.
- Completes annual employee health requirements within established timeframes.
- Maintains license/certification, registration in good standing throughout fiscal year.
- Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
- Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
- Adheres to regulatory agency requirements, survey process and compliance.
- Complies with established organization and department policies.
- Available to work overtime in addition to working additional or other shifts and schedules when required.
Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
- Leverage innovation everywhere.
- Cultivate human talent.
- Embrace performance improvement.
- Build greatness through accountability.
- Use information to improve and advance.
- Communicate clearly and continuously.
Education and Experience
Pharmacy or a Pharm D Degree from an accredited college or university. A license or demonstrated eligibility for licensure, to practice pharmacy in Indiana is required. A successful completion of PGY1 and/or PGY2 residency with subsequent BCACP or BCPS certification in good standing is preferred. In lieu of residency, a minimum of two-three years of experience in clinical pharmacy practice (ideally with ambulatory care) is preferred; the clinical experience is required if education is a Bachelor's Degree.
Knowledge & Skills
- Demonstrates thorough knowledge of policies, procedures and standards for the provision of pharmaceutical services, drug therapy and current treatment modalities.
- Demonstrates solid data collection skills.
- Demonstrates the interpersonal skills necessary to interact effectively with others, in order to ensure the provision of pharmaceutical services.
- Demonstrates good communication skills, both verbal and written.
- Must be able to communicate in a tactful, sincere, effective manner with patients, families, Physicians, other healthcare professionals and various Hospital staff.
Working Conditions
- Works in an office environment.
- Occasional exposure to potentially hazardous substances.
Physical Demands
- Requires the physical ability and stamina to perform the essential functions of the position.
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