Value Based Care Clinical Pharmacist
hace 29 días
Denver
Job DescriptionDescription: We're Hiring: Value Based Care Clinical Pharmacist – Hybrid in State of Colorado Join Carina Health Network and help us make Colorado communities healthier! Are you passionate about population health and interested in improving patient experience and outcomes? We support community health organizations across Colorado with technology, data, and resources that help people get the care they need, when and where they need it. If you're looking for a mission-driven organization where your work has a real impact in real communities, Carina could be the right place for you. At Carina Health Network, we’re transforming community health by helping our members deliver proactive, data-informed, and whole-person care that drives measurable impact. Our work helps people with chronic conditions like diabetes and high blood pressure stay healthier, ensure older adults get regular check-ups, and identify mental health needs early. We help reduce unnecessary emergency room visits by connecting people with the right care at the right time. Join us in reimagining the future of health care, where your work truly matters. Job Summary The Clinical Pharmacist plays a key role in advancing population health initiatives and optimizing performance across value-based care (VBC) programs. This role will support community health centers (CHCs) and contribute to clinical programming, quality improvement, and risk adjustment initiatives within the Clinically Integrated Network (CIN), Medicare Shared Savings Program, Medicare Advantage, and other VBC contracts. The Clinical Pharmacist is responsible for leading medication management for patients with chronic conditions, with a primary focus on diabetes and hypertension, including oversight of remote patient monitoring (RPM) for these conditions. This role provides clinical oversight and strategic direction for medication optimization, adherence interventions, and pharmacy technician workflows. The Clinical Pharmacist also plays a key role in supporting Medicare Advantage (MA) contracts, including performance on Stars and HEDIS measures, through evidence-based medication management and quality improvement initiatives. What You’ll Do Chronic Disease Management: • Provide clinical oversight for medication management for patients with diabetes and hypertension., • Optimize medication regimens based on clinical guidelines, patient-specific factors, and barriers to adherence., • Conduct comprehensive medication reviews, including identification of polypharmacy risks, drug interactions, and therapeutic duplication., • Support clinical teams in medication titration protocols under collaborative practice agreements, where applicable., • Actively manage patients enrolled in RPM by reviewing blood pressure and glucose readings, conducting patient outreach to address abnormal values, providing education and coaching, and supporting medication changes as needed., • Establish medication adjustment workflows aligned with RPM data and escalation protocols., • Review RPM dashboards and trends to proactively identify patients needing intervention., • Collaborate with care teams and providers to act on RPM alerts and abnormal readings., • Oversee pharmacy technician workflows supporting medication adherence calls, refill alignment, outreach, and education., • Design, implement, and refine adherence strategies (e.g., refill sync, cost mitigation, side-effect counseling)., • Prioritize patients for adherence support using pharmacy claims data, risk stratification lists, and payer adherence thresholds., • Understand medication-related quality measures (i.e., Statin Use in Persons with Diabetes, Diabetes Control, Controlling Blood Pressure)., • Identify performance gaps and partner with clinical and network teams to design pharmacist-led interventions that improve quality metrics., • Support documentation improvement and close care gaps through chart review, patient outreach, and provider education., • Use clinical, claims, and RPM data to identify trends, gaps, and opportunities for improvement., • Develop and track outcome metrics related to medication optimization, adherence improvements, and chronic disease control., • Contribute to dashboards, scorecards, performance reviews, and reporting for internal and external stakeholders., • Work closely with physicians, advanced practice providers, care managers, and medical assistants to coordinate patient care., • Provide education on pharmacotherapy best practices, new medications, and guideline updates., • Participate in provider engagement meetings., • Ensure all pharmacy activities comply with state and federal regulations and organizational policies., • Maintain up-to-date knowledge of guidelines, best practices, MA quality program requirements, and medication safety standards., • Contribute to the development and updating of policies, procedures, and protocols that support medication management and adherence. What We’re Looking For, • Doctor of Pharmacy (PharmD) from an accredited school of pharmacy., • Active, unrestricted pharmacist license in [state] or eligibility to obtain., • 3–5 years of clinical pharmacy experience in ambulatory care, primary care, population health, or chronic disease management. FQHC experience preferred., • Active Colorado license or ability to obtain one by start date., • Demonstrated experience managing diabetes and hypertension medications., • Strong data interpretation, communication, and patient engagement skills., • Demonstrated knowledge of CMS-HCC risk adjustment, Medicare Advantage, and alternative payment models., • Strong understanding of population health, quality improvement, and clinical workflow design., • Proficiency in data interpretation, health care analytics, and performance measurement., • Board certification (BCACP, BCPS, CDCES, or equivalent)., • Experience with remote patient monitoring programs for chronic conditions., • Experience in Medicare Advantage, Stars, and/or HEDIS performance improvement., • Familiarity with value-based care, ACO operations, CINs, or managed care environments., • Comfort using EHRs, population health platforms, and pharmacy claims systems., • Bilingual or multilingual skills reflective of the communities served.Why You’ll Love Working Here, • Insured group health, dental, and vison plans (Employer covers 100% of the cost for dental and vision), • Medical and dependent care flexible spending account options, • Employer contributions $900 annually towards a Health Reimbursement Employer (HRA) or Health Savings Account (HSA), depending on the health plan selected, • 401k retirement plan with up to a 4% employer contribution match, • 100% employer-paid life, AD&D, short-term, and long-term disability plans paid for employees, • Free 24/7 access to confidential resources through an employee assistance program (EAP), • Voluntary benefit plans to complement health care coverage, including accident insurance, critical illness, and hospital indemnity coverage, • 17 days of paid vacation within one year of service, • 12 paid sick days accrued by one year of service, • 14 paid holidays (which includes two floating holidays), • One paid volunteer day, • Employer-paid programs/courses for professional growth and development, • Cell phone and internet reimbursement, • Competitive salary and full benefits, • Annual, all expenses paid staff retreat, • Flexible work (remote or hybrid), • Supportive, mission-driven team Carina Health Network provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This role will be posted until 1/31/2026 or until filled. Salaried Rate: $125,000 - $150,000/year Requirements:
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