Cedars-Sinai Drug Use Policy Pharmacist in United States
The Drug Use Policy Pharmacist (DUP) will serve as the primary professional staff member in the Department of Pharmacy responsible for the clinical and medication use policies within Cedars-Sinai Medical Care Foundation (CSMCF). The responsibilities cover all aspects of medication use policy analysis, from the development of the new policies to oversight of medications within CS-Link, our EMR system.
The DUP is responsible for the identification, execution, and follow-up on high cost medication usage evaluations and recommendations for the patient population within CSMCF. The goal of this role is to guide the organization to provide timely, appropriate, and cost-effective drug therapy to our patients. This DUP will lead the charge by analyzing pharmaceutical usage and cost trends and work with the appropriate internal parties to develop clinical initiatives focusing on methods to achieve cost reduction around targeted therapies.
This position requires a strong comfort level of data analysis, prior knowledge of high cost drug classes, strong analytical skills and an ability to lead at a cross-functional level by stewarding recommendations forward within various leadership forums, including the CSMN Physician Leadership, P&T Committee, and other CSHS Leadership.
Once targeted therapies are identified, the DUP is responsible for putting new policies in place, and educating the staff and physicians on the approach and to ensure that the processes, programs and services are accomplished in a timely and efficient manner. Additionally, providing clinical support and oversight for all utilization management (UM) activities on an ongoing basis, in accordance with CSMCF policies and procedures and in compliance with applicable state and federal regulations, including CMS and/or Medicare Part D and Medi-Cal, as well as accreditation standards such as NCQA.
ESSENTIAL DUTIES & RESPONSIBILITIES:
•Analyze pharmacy costs of care, trends, and coordinate the development of appropriate use protocols and guidelines. Prior experience highly desired.
•Develop drug product review and recommendations by assessing drug use trends, new drug releases and review of primary literature. Prior experience in drug policy analysis and drug formulary management highly preferred.
•Critically evaluate and interpret data from various sources to provide an accurate and balanced response within the guidelines and regulations of industry-based drug information practice.
•Set criteria for medication review of non-formulary or non-preferred drug list medications and communicate recommendations.
•Research drug information to maintain drug knowledge and disease state understanding. Monitor pipeline medications and new medication research.
•Provide support documentation and develop communication for the Pharmacy & Therapeutics (P&T) Committee review process and decisions.
•Provide education to physicians, nurses, pharmacists and allied health care professionals regarding safe medication use or changes in medication policy. Triage and respond to drug information inquiries from physicians, pharmacists, nurses and other health care professionals. Some patient correspondence may occur.
•Assist with training of pharmacy residents and pharmacy students and with continuing education activities for pharmacy staff, and when appropriate, physicians.
•Review drug usage data and make determinations for drug products according to member benefits and coverage criteria.
•Assist with budget forecasting and management.
•Complete projects related to clinical pharmacy and medication use improvement, as needed.
•Assist with implementation and education of new order sets, best practice alerts, updating drug lists, and other work related to medication use within Cedars-Sinai’s electronic medical record system, CS-Link (Epic).
•Takes a lead role in the implementation of new drug-related initiatives and the establishment of new clinical pharmacy services or initiatives as requested.
•With the team, develops and implements clinical criteria for the review of non-formulary or non-preferred medications.
•Reviewing and revising scripting for patient and prescriber communication (e.g., criteria, letters) related to drug coverage and other drug utilization programs.
MINIMUM JOB REQUIREMENTS/COMPETENCIES:
Educational requirements and/or preferences (Licensure, Registration, Certification, Experience, Other):
•Must have a current and unrestricted California pharmacy license.
•PharmD degree required
•Three years or equivalent combined experience of managed care pharmacy or pharmacy residency program experience (PGY=1 and/or PGY-2 residency)
•Pharmacy benefit management or managed care experience highly preferred
•Experience in drug information/drug policy or a specialty area (particularly hematology/oncology, infectious disease or cardiology) are preferred.
•Knowledge of or experience with Medicare Part D prior authorization requirements, including reviewing drug use criteria for medication approval
•Possesses excellent computer skills. Experience in MS Office, particularly Excel, Word and Powerpoint).
•Ability to learn and adapt to the use of automated information systems (EHRs) in daily practice.
•Possesses experience in drug information services and formulary development
•Possesses excellent verbal and written communication skills.
•Ability to establish effective working relationships with physicians and medical professionals
•Ability to organize work effectively, determine priorities, work well independently as well as in a team environment
•Comprehensive knowledge of common disease states and pathologies.
•Ability to comprehend patient medical management plans.
•Knowledge of laws, regulations and standards relative to outpatient pharmacy.