Typical Responsibilities/Accountabilities

• The Practitioner is broadly subject to functional policies and goals and/or managerial direction. Incumbents have wide discretion to act consistent with operating policies and procedures.
• Representative duties include, but are not limited to, the following:
  • Conduct comprehensive medication reviews for eligible members Utilize prescription, data to complete a Comprehensive Medication Reviews.
  • Communicate with members and providers to resolve drug therapy problems.
  • Provide clinical recommendations pertaining to, but not limited to, missing and duplicate drug therapies, gaps in care, high risk medications, medication compliance and adherence, drug interactions, therapeutic substitution, and generic substitution based on medication review and reconciliation.
  • Identify and help resolve barriers to adherence; maximize utilization of generics or lower cost brand alternatives and reduce polypharmacy.
  • Utilize formulary and member specific benefits to guide appropriate medication recommendations.
  • Validates and quality checks all documents and reports to ensure accuracy.
  • Conduct member level medication counseling and disease education.

Typical Education/Experience

• BS or PharmD in Pharmacy
• Current Florida licensure
• Medication Therapy Management certified or Minimum 3 years of MTM experience.
• PBM or Insurance Plan work experience preferred

Suggested Competencies

Cost Control – Uses member’s formulary to look for ways to reduce cost.

Communication – Communicates well verbally and in writing; creates accurate and punctual reports; delivers presentations; shares information and ideas with others; has good listening skills.

Customer Focus – Builds customer confidence; is committed to increasing customer satisfaction; sets achievable customer expectations; assumes responsibility for solving customer problems; ensures commitments to customers are met; solicits opinions and ideas from customers; responds to internal customers.

Decision Making/Judgment – Recognizes problems and responds; systematically gathers information; sorts through complex issues; seeks input from others; addresses root causes of issues; makes timely decisions; can make difficult decisions; uses consensus when possible; communicates decisions to others.

Interpersonal Skills – Has good listening skills; builds strong relationships; is flexible/open-minded; negotiates effectively; solicits feedback and handles constructive criticism.

Managing Conflict – Listens well; diffuses conflict before it starts; finds causes of and solutions to problems; handles difficult people.

Organizational Savvy – Operates within the organization’s formal and informal structures; builds allies and relationships across departments; uses allies to build consensus and create results; is appropriately diplomatic; understands others’ roles and perspectives; can sell project ideas across the organization.

Problem Solving/Analysis – Breaks down problems into smaller components; understands underlying issues; can simplify and process complex issues; understands the differences between critical details and unimportant facts.