Value-Based Care Clinical Pharmacist at Kootenai Health – Coeur d'Alene, Idaho

Value-Based Care Clinical Pharmacist

Job Code: 29192

Position Summary

The value-based care clinical pharmacist is a position that evaluates patients in the Kootenai Care Network (KCN) for appropriate and cost-effective therapies. The goal of this position is to improve overall health outcomes and maintain high quality of care. The pharmacist will perform comprehensive medication reviews, formulary management, prior authorization evaluations, quality improvement efforts, and other duties as assigned based on experience and training. Responsible for medication sensitive measures in value-based contracts. Reports to the Executive Director of KCN and has a clinical connection to a pharmacy manager.

Responsibilities

• Assesses the utilization of high-cost medications and biologics, as well as appropriateness of sites of care, based on policy and clinical guidelines

• Monitors and ensures proper use of high-cost or high-risk medications to achieve optimal clinical and financial outcomes

• Develops and maintains Quality Assurance (QA) programs that enhance patient safety, improve medication use, and deliver the highest standard of care

• Conducts outcomes-based research to assess the real-world performance of therapies and guide medication-related decision-making

• Designs and evaluates medication management programs that align with evidence-based practices

• Develops educational materials to support providers in improving HEDIS and CMS Stars measures

• Designs and implements strategies to improve member experience and healthcare outcomes

• Conducts drug utilization reviews, including those targeting specific disease states like multiple sclerosis or opioid management, to ensure safe and effective use of medications

• Provides evidence-based recommendations on formulary inclusions, exclusions, and restrictions

• Analyzes clinical data and creates actionable recommendations to the team and provider network

• Performs other related duties as assigned

• Familiar with standard concepts, practices, and procedures within the value-based care model

• Relies on experience and judgment to plan and accomplish goal

• Regular and predictable attendance is an essential job function

• Competent to meet age-specific needs of the unit assigned

Requirements and Minimum Qualifications

• Doctor of Pharmacy with minimum of 2 years’ post graduate experience in patient care OR BS and residency or board certification or with 5 years’ post graduate experience in patient care OR BS with 10 years’ post graduate experience in patient care

• Must be licensed and/or License eligible in the state of Idaho. Licensure must be obtained within 60 days of date of hire.

• Proficiency with electronic health record and other data management technology

• Strong communication skills for collaborating with patients, providers, and healthcare teams

Working Conditions

• Must be able to maintain a standing and/or sitting position

• Typical equipment used in a clinical and office job

• Repetitive movements

• Must be able to bend, stoop, or crouch

• Must be able to reach arms above or below shoulder height

• Must be able to lift and move up to 10 lbs