Pharmacist Care Navigator - 32 hours/week - Evernorth - California

Pharmacy Care Navigator - Clinical Pharmacist Part time 32 hour/week - California (remote)

Pharmacy Care Navigators are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers and families.

The Pharmacy Care Navigator is responsible for working with other members of the Pharmacy Care Team to ensure Evernorth is delivering on its promise to help members navigate and maximize their benefit, help improve clinical outcomes and optimize drug therapy.

Day in the Life Responsibilities:


* Reviews pharmacy data to extract market and member trends to develop targeted interventions.


* Navigation of multiple analytical programs and clinical systems that will provide data to improve clinical and financial outcomes and support trend management.


* Collaborates with case management, behavioral clinician, Medical Director, and member's provider to provide whole-person health support.


* Participate and collaborate in an innovative, targeted program that drives improved outcomes for a high-needs population.


* Perform targeted evaluations of available customer health records and using evidence-based medicine, educate and engage customers in successfully managing their drug regimen and chronic conditions.


* Establish credibility as a trusted partner and advisor to our provider partners, including interventions and recommendations to address quality measures and other clinical pharmacy concerns based on evidence-based protocols and guidelines.


* Assists in driving customer to cost effective treatments, including brand-to-generic medication utilization.


* Close gaps and barriers to medication adherence and assisting customers with compliance of 90-day refill rates versus 30-day, driving utilization of home delivery through pharmacy benefits manager (PBM).


* Provides clinical consultation and drug information to matrix partners and navigator team:
+ General medication questions
+ Medication regimen reviews/consultations
+ Medication reviews for polypharmacy
+ Safety concerns
+ Medication adherence
+ Gaps in care
+ Adherence to evidence-based treatment guidelines
+ Drug information (side effects, interactions, etc.)



* Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.


* Participates in rapid-cycle improvement processes with daily work/focus shifting to meet member trends.


* Tracks daily activities to trend volume and outcomes.


* Toggles between multiple systems and applications.


* Prioritizes work to meet commitments aligned with organizational goals.


* Understands and adheres to organizational performance measures to deliver on key results.


* Completes training within the communicated time limit as required per role....