Clinical Pharmacy Analyst
hMetrix is a cutting-edge healthcare analytics firm that partners with providers, payers, HIEs, and other healthcare domain entities to manage data collection, validation, integration, analysis, and visualization. The company’s decades-long focus on healthcare has generated deep expertise in the nuances and complexities involved in the effective use of healthcare data to solve real-world problems.
Working in a close partnership model with its clients, hMetrix jointly defines problems and tailors data resources, processes, and technologies to meet those needs. hMetrix embraces a collaborative, participatory work style that 1) ensures the accuracy and relevance of results, 2) facilitates the efficient, scalable utilization of resources, and 3) promotes rapid deliverable turnaround. Working at the cutting edge of data science, data management and analysis technologies, hMetrix offers unique and innovative solutions.
Responsibilities
- Provides safe, efficient, patient-centered, evidence-based medication services resulting in the optimization of medication therapy. Comprehensive review and evaluation of medication therapy to identify and prevent potential or actual medication related problems and gaps in therapy as well as take appropriate actions to resolve them
-
CMTR
- Reconciling medications
- Member-centric review of a member’s medication therapies for health plan transition of care and quality programs, looking at factors such as co-morbidities and evidence-based guidelines to optimize medications for the individual
- Reviews all prescribed and non-prescribed medications for appropriateness and uncovers untreated clinical indications, multiple prescribers, multiple pharmacies, improper medication selection, sub-therapeutic and excessive dosage, medication interactions, medication use without an indication, complex medication regimens such as specialty drugs and biologics, adverse effects that the member might be experiencing and addresses any adherence issues
- Formulates a written summary of patient centric medication therapy findings and recommendations and communicates with the provider for resolution of issues
- Tracks all medication therapy findings, recommendations, resolutions, and acceptances
- Assists in preparation of clinical pharmacy reports
- Ability to perform medication therapeutic review and provide clinical insights
- Use computerized workflows to manage the process
-
Consulting
- Knowledge of prescription drug benefit design
- Identify fluid issues faced by clients and provide recommendations and innovative solutions to the issues
- Knowledge of Medicare Part D
-
Knowledge of prescription drug benefit quality programs
- Medicare Part D Star ratings
- Opioid overutilization strategies
- Benefit Manager (PBM) oversight to review potential issues and identify risk
- Participate in weekly hospital admissions care team case conferences
-
Data and Innovation
- Use knowledge of data to identify how it can be used
- Innovate - look for opportunities to improve processes and offerings
- Use Microsoft Office (Word, Excel, and PowerPoint) for collaboration and documentation
Requirements
- Doctor of Pharmacy degree or Doctor of Medicine degree required
- 2+ years patient centered clinical experience required
- Experience in managed care, medical and pharmacy claims strongly preferred
- Medication Therapy Management Certification (MTM) preferred
- Experience in quantitative techniques such as statistics preferred
- Experience analyzing large volumes of data using programmatic methods preferred
- Ability and willingness to work effectively with geographically distributed teams across time zones
Benefits
This full-time position is based in our Bala Cynwyd, PA, office with up to 5% travel during normal operations. Full remote work with no travel assumed while Covid-19 pandemic restrictions are in place.