This position is responsible for leading, coordinating, and developing clinical pharmacy activities and initiatives for the Managed Pharmacy Solutions (MPS) business line within Banner Pharmacy Services (BPS). This includes the creation and management of a customized formulary that will be used by Banners risk based partners. Responsible for the creation and maintenance of a Pharmacy and Therapeutics committee using current Banner medical and pharmacy experts as well as external experts. Responsible for the development, implementation, maintenance and evaluation of clinical utilization management programs designed to lower drug expense while improving quality within the pharmacy benefit programs. Collaborates with internal and external clinical teams to review various analytic material in order to improve overall medication use and quality. Serves as part of a team that develops and presents complex clinical ideas and strategies based on sound analytical information to non-medical personnel in an easy to understand format. Oversees a team of pharmacists whose mission is to improve medication cost and quality through interaction with Banner prescribers, risk based partners and Pharmacy Benefit Managers (PBM).
Responsible for leading, coordinating, and developing clinical pharmacy activities and initiatives for the Managed Pharmacy Solutions (MPS) business line within Banner Pharmacy Services (BPS). Works collaboratively with MPS business partners including Banner employee benefits leaders, joint venture payer partners, various PBM teams, Banner Health Network (BHN) providers and staff, Banner Medical Group (BMG) providers and staff and BPS business line leaders to meet clinical business needs.
Utilizing internal and external medical personnel, create and maintain an outpatient based P&T Committee that develops a custom formulary that will be applied to various Banner Health risk partners (Joint Venture, ACO and other risk based arrangements) that request the application of our custom formulary. Creation and maintenance of policies and procedures that ensure alignment with the standards and requirements for various governing agencies (CMS, URAC, etc). The goal of the P&T Committee is to create and maintain a customized formulary, develop and maintain customized prior authorization strategy and criteria meant to steer patients and providers to the most beneficial therapy, and create and maintain various clinical plan design features including step therapies, quantity edits, age/gender edits, etc. This work is guided by evidence-based medicine and involves continuous review of the formulary to identify opportunities to standardize and optimize medication use.
Work with BPS Business Line leaders to create and maintain integrated clinical pharmacy services designed to guide prescribing to the most efficient and effective therapy based on P&T Committee recommendations, provide physicians with population and patient information regarding individual and population level medication use and suggest prescribing changes designed to achieve optimal medication therapy management. This will require leading a team of pharmacists and other healthcare professionals that report directly as well as those that do not report directly to this role.
Work closely with the leaders of the clinical pharmacy informatics program across the continuum of care to ensure the health information system supports goals of MPS and the partners served by MPS. Collaborate with key stakeholders, departments, and other individuals to improve medication use among the various health information systems and medication-related technology. This involves leveraging Cerner applications to optimize safe and appropriate medication use across the system.
Work directly with external vendors to ensure the correct design and set up of various clinical applications provided by Banners external vendor partners. This will require collaboration with external vendors on the strategy, development, construction and testing of all clinical based programs designed to support efficient medication management across provider and patient populations.
Function as an agent of change to design, develop, coordinate and implement programs and methods to improve medication utilization. Collect, analyze, and report information regarding the most current drug therapies. Participate in drug utilization evaluations and quality improvement processes.
Participate in the development of system policies, procedures, and clinical practices that pertain to medication use, medication safety, formulary management, and clinical pharmacy services.
Helps to support Banner partners that operate Medicare Part D program.
Requires an advanced pharmacy degree (e.g., Pharm.D.) and completion of an ASHP-accredited pharmacy practice residency (or equivalent experience).
Requires current pharmacy or eligibility for licensure in the applicable state of practice, a degree in Pharmacy from an accredited College of Pharmacy.
Must have at least 5 years of clinical pharmacy experience.Must have a working knowledge of the Medicare Part D program.Requires a strong working knowledge and significant experience with formulary management, clinical pharmacy services, and health information technology. Must be familiar with the economic drivers of healthcare and emerging trends related to medication use and the practice of pharmacy. Must possess excellent verbal and written communication skills for interfacing with all levels of staff, physicians, and organizational leaders. Requires the ability to create collaborative working relationships. Must have a successful track record in design and implementation of new programs, services, or initiatives. Must demonstrate analytical, problem solving, project management, critical thinking, and organizational skills in a complex environment. Must have a familiarity with analytical programming and clinical systems. Must have knowledge of medication management software.
2-3 years experience in a pharmacy managed care environment in a health plan or Pharmacy Benefit Management environment. Certification by the Board of Pharmacy Specialties (e.g., BCPS).
Additional related education and/or experience preferred.
Internal Number: 208982
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.