At Shields, we pride ourselves on our culture of inclusion and kindness and the difference we make in patients' lives every day. We are tremendously proud to be certified as a ‘Great Place to Work’ four years in a row. In 2022, we were awarded US Fortune Best Workplaces in Health Care™, Fortune Best Workplaces for Millennials™ & Fortune Best Workplaces for Women™.
Improving lives and elevating performance are at the heart of everything we do. That’s why more health system leaders trust Shields to elevate access, outcomes and growth within specialty pharmacy — delivering value throughout the entire health system. Leveraging our proven Shields Performance Platform – we deliver the financial results that health systems demand and the superior outcomes patients deserve. With the foremost leaders in specialty pharmacy on our team; proven success partnering with more than 70 health systems; and a vested interest in delivering measurable results – we are the partner health systems trust to transform their specialty pharmacy into a powerful growth engine and elevate performance where it matters most.
Job Purpose:
Provides on-site integrated support to patients and physicians by providing a 'hands-on" approach to total quality patient care through the delivery of a full continuum of medication administration from giving pharmacological information to monitoring patient drug therapies and providing adherence support.
Completion of PGY2 residency specializing in one of the following disease states is required: Oncology, Infectious Disease, Inflammatory Disease (Rheumatology/Gastroenterology) or Neurology.
Job Duties:
The Clinical Pharmacist will help advance quality pharmacotherapy care by actively assuring the provision of safe, efficacious and cost-effective drug therapy for all assigned specialty patients. The clinical pharmacist works in an outpatient specialty practice and collaborates with all team members utilizing a collaborative practice-based care team model. The pharmacist provides face-to-face and one-on-one phone-based disease management with patients. Responsible for the review of prior authorization requests for medications requested under the pharmacy benefit. The pharmacist will utilize integrated and routine communication with all health care professionals and the patients concerning medical care and quality of life with the emphasis placed on the monitoring and documentation of specific pharmacotherapy outcomes. The clinical pharmacist will consult with the patient to identify, resolve and prevent medication related problems. The clinical pharmacist assesses each of the patient's medications for indication, effectiveness, safety and adherence issues
Medication therapy management, including reviewing and monitoring of medication regimens, advising clinicians on evidence-based therapy as indicated, documenting interventions;
Have the ability to review patients' clinical chart information and determine the appropriateness of requested treatment
Monitor and review prior authorization requests for medications;
Develop clinical criteria and medical policies for the review of medications;
Ensure all clinical criteria is in regulatory compliance with Center of Medicare and Medicaid Services (CMS).
Ensure all clinical criteria is in clinical compliance with guidance from the Food and Drug Administration (FDA), clinical guidelines, and appropriate evidence-based literature.
Manage, organize, and update relevant data using database applications;
Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards;
Actively participates in process improvement initiatives;
Protects organization's value by keeping information confidential;
Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations;
Willing to do whatever is necessary for the betterment of the Company;
Other duties as assigned.
Experience/ Education:
Required Licensure/Certification: Applicant must hold a Doctor of Pharmacy (PharmD) and be a licensed Pharmacist in state of employment.
Years of Experience: Completion of PGY2 residency specializing in one of the following disease states is required: Oncology, Infectious Disease, Inflammatory Disease (Rheumatology/Gastroenterology) or Neurology.
Skills: Ability to analyze information, exercise good judgment, possess strong verbal communication skills, have deep knowledge of pharmacology developments and FDA health regulations. Ability to manage processes, exhibit strong technical and clinical skills, maintain constant focus on legal compliance, while being highly productive with a focus on quality and details. Must be computer proficient (knowledge of the "Rx30" software system a plus). Strong clinical knowledge of pharmaceuticals and disease states in order to conduct prior authorization reviews. Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits.
Traits: Organized, high-integrity, attention to detail, dependable, quality focus, empathetic, good listener/communicator
Other: Energetic, highly motivated, team player with strong personal and communication skills; discretion and confidentiality essential as position deals with highly sensitive and private data
About Shields Health Solutions at Spartanburg Regional Health System
With the foremost leaders in specialty pharmacy on our team; proven success partnering with more than 80 health systems across the country; and a vested interest in delivering measurable results – we are the partner of choice for health system leaders who want to transform specialty pharmacy into a powerful growth engine and produce superior patient outcomes. Together, we expand payor and drug access; improve therapy management and care coordination; deliver unsurpassed patient experiences; and generate the net operating income needed to accelerate growth at health-system owned specialty pharmacy, whether new or existing.
Shields Health Solutions is a great place to work and an ideal community for anyone who loves an entrepreneurial environment. Be part of an innovative culture where employees have the freedom to explore new opportunities, chart their own course and make a real difference in the lives of the people we serve – patients living courageously with chronic, complex illnesses.
Make a significant, meaningful impact from day one as a member of a close-knit team that helps everyone be successful.