Manager, Population Health Pharmacy Patient Liaison

POSITION SUMMARY:

Boston Medical Center Health System (BMCHS) provides a population health pharmacy service to serve the complex medication needs of patients in our accountable care organizations (ACOs) as well as those part of other risk-based contracts. BMCHS will provide patients a comprehensive population health pharmacy service program that includes retail and mail-order pharmacy-based programs staffed with a care team that includes pharmacists and pharmacy liaisons. The cornerstone of BMCHS pharmacy’s approach is an unparalleled level of integration with care teams coupled with a highly personalized service, thus driving better outcomes at lower cost.

The Pharmacy Patient Liaison (PPL) Manager will be responsible for program development, personnel and operational management of liaison-driven programs under Population Health Services (PHS), and in partnership with Boston Medical Center Health System (BMCHS) Pharmacy.  The manager oversees daily operations of population health PPLs, and provides leadership through training, coaching, and teaching.  In coordination with multidisciplinary clinical teams, pharmacy staff and PHS teams, the manager provides a full continuum of integrated, patient-centered, and coordinated pharmacy support to manage the pharmacy needs of ACO patients and partners, as well as those part of other risk-based contracts.  The supervisor also works with clinical and operational pharmacy leaders to optimize and integrate PPL interventions and workflows, manage and track performance of programs, and support professional development and competencies of the PPL staff.

Position: Manager, Population Health Pharmacy Patient Liaison       

Department: Pop-Health Pharm

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

The Population Health Pharmacy Patient Liaison Manager will:

Program Development

• Oversee the retention and management of existing patient panels and growing enrollment of target patient populations into population health pharmacy adherence programs. 
• Optimize the role of panel management and pharmacy tools and applications to best support tracking of enrolled patients and management of medication needs
• Identify key drivers of medication adherence for patients with medication complexity during the full continuum of care (e.g., hospital discharge, chronic disease management), and work to ensure liaison-provided services adequately meet the medication needs of the patient 
• Maintain working knowledge of the ACO’s pharmacy benefit and formularies, as well as other risk-based contracts, to navigate and anticipate the pharmacy benefit needs of ACO patients and their providers
• In partnership with the Senior Clinical Manager, collaborate with BMCHS pharmacies and other in-network pharmacies to ensure that ACO patients, as well as those part of other risk-based contracts, are able to access and benefit from the multitude of adherence-supporting services that are available.
• Under the direction of the Senior Clinical Manager, assist in developing workflows and integrating Population Health Pharmacy Liaison interventions at clinical practice sites in our Medicaid/MassHealth accountable care organizations (ACOs)
• Lead the development, implementation and revision of policies affecting overall pharmacy liaison operations, quality of care and patient satisfaction
• Identify root causes of issues; distill to identify themes and make recommendations towards resolution
• Partner with clinical and operational pharmacy leaders to design new processes and support quality improvement
• Contribute to the advancement of the pharmacy technician and liaison role
• Contribute to the development of medication-related trainings and tools
• Build strong and constructive relationships with stakeholders
• Pursue opportunities to increase visibility of Pop Health Pharmacy liaison programs
• Identify opportunities to optimize pharmacy liaison impact and workflow efficiencies

Operational Responsibilities  

• Oversee day to day operations for pharmacy liaison interventions supporting Pop Health Pharmacy programs
• Maintain effective and appropriate staffing. Monitor employee turnover, overtime, and absenteeism
• Monitor staff to ensure that all required documentation is properly completed for clinical and administrative purposes
• Support resolution of complex medication-related issues. Involve or escalate to clinical managers, operational managers, and/or clinicians as needed
• Effectively communicate with Population Health Pharmacy Leadership, BMCHS Pharmacy Department Leadership, population health administrative and medical leadership, in support of population health-based initiatives
• Provide and analyze metrics on health system-wide and/or department focused initiatives
• Under the direction of the Senior Clinical Manager, develop KPI reporting and action planning for PHS liaison-driven interventions
• Standardize liaison workflows and reporting where applicable across PHS Pharmacy programs
• Identify opportunities to innovate and optimize workflows

Personnel Development  

• Recruit, hire, train and support new staff in understanding and learning the expectations for day-to-day operations in a specific role
• Work with Pharmacy management to establish individual performance goals. Responsible for the overall accountability of each program area, ensuring staff are meeting outreach, enrollment and program goals. 
• Monitors performance against goals. Plans, approves, and implements actions for the timely development and progress of Pharmacy Liaisons.
• Effectively manages assigned staff to include training, directing, mentoring and instilling a commitment to quality and excellence.
• Cultivate leadership and coaching skills by training, mentoring and providing support to assigned Pharmacy Liaisons and support staff; provide team development, skills, and responsibilities, including but not limited to:
  • Developing unit/department goals that are aligned with the corporate goals.
  • Monitoring productivity and performance to identify and evaluating program/ department strengths and training opportunities in relation to operational effectiveness.  Report on metrics as outlined by management and departmental leadership
  • Encouraging staff and personally advancing professional growth and development through participation in educational programs and workshops and maintaining knowledge of industry standards and practices.
• Handle all patient related questions, problems and complaints for the liaison-driven services provided within our population health pharmacy programs or as a result of Liaison work in person and/or via the phone. Reviews and resolves all issues to ensure compliance and satisfaction of legal requirements, company objectives and customer satisfaction.
• Develop and grow trusting relationships with pharmacists, providers and hospital staff to provide the highest level of care for patients with complex needs
• Maintain and support pharmacy interdepartmental relationships to ensure seamless transition of patient care from clinic to pharmacy
• Develop orientation and training materials for new hires
• Actively lead personnel development, goal setting and monitoring

Patient Care

• Serve as a subject matter expert and model for pharmacy liaisons’ primary responsibilities on benefit navigation and medication adherence. This includes:
  • As a member of the care team, work seamlessly alongside hospital clinicians to serve patients both face-to-face and over the phone.
  • Resolve insurance related issues, including prior authorizations (PA’s) and assist patients with filling out various forms of financial assistance.  Communicate cost-sharing responsibilities with patients, as applicable.
  • Function as a direct interface between providers, patients, pharmacy and insurers on matters related to insurance verification, pre-certification/authorization.
  • Communicate directly with patients to assist them in the navigation of their medications.
  • Build a trusting and working relationship with patients to identify strengths and barriers to medication access with the goal of supporting an individualized, patient-centered care plan
  • Submit retail/specialty pharmacy prior authorizations in compliance with BMCHS’s policy and procedures
  • Obtain medication refill histories
  • Navigate the EMR (electronic medical record) and other resource tools to effectively answer questions and resolve issues
  • Clearly document and communicate via various modalities including, but not limited to in-person, telephonic, and EMR-based platforms. 
• Provide coverage for pharmacy liaisons as needed

Other duties:

• Participate in departmental and organizational committees as assigned
• Orient and train other departmental staff to assist as necessary
• Responsible for the creation and maintenance of a healthy work environment. A healthy work environment is one where people feel supported, held accountable, where standards are applied and expectations are clear. A healthy work environment is one where leadership supports and leads, models behavioral standards and sets the example for how to do all things right.
  
  Critical responsibilities related to this:
• Being engaged in the department, including managing up, owning team decisions and communicating and supporting departmental and or organizational initiatives
• Hold self and others to the highest ethical standards, and act with honor above all
• Effective human resource management, including effectively disciplining people in accordance with established policies, recognizing people, completing performance evaluations and guiding people in professional development.
• Adapts to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc.
• Utilizes hospital’s behavioral standards and RESPECT attributes as the basis for decision making and to support the hospital’s mission and goals.
• Perform other duties as assigned or as necessary.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

• HS Diploma or G.E.D. required
• AA or BA preferred

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• Must be currently registered as a Pharmacy Technician with the Board of Pharmacy in Massachusetts.
• Pharmacy technicians must have current active National Certification verified by PTCB or ExCPT

EXPERIENCE:

• Must have 4-5 years of pharmacy-related experience
• Retail pharmacy experience preferred
• Management experience preferred

KNOWLEDGE AND SKILLS:

• Excellent English oral and written communication skills required; as well as ability to communicate professionally over the phone.
• Excellent interpersonal skills to provide superb personalized customer service and to instill confidence and to advocate for patients; ability to explain required information to patients in a comprehensible manner.
• Other professional skills and qualities: organization, strong attention to detail, ability to self-direct through multitasking and prioritizing, dependability, empathy, focus on quality service, goal oriented.
• Capacity to work independently and self-manage workload to meet established goals in a fast-paced environment
• Cultural sensitivity, understanding, and comfort with a wide range of social, racial and ethnic populations.
• Must practice discretion and confidentiality as position deals with highly sensitive and private data.
• Ability to understand, explain, and actively promote the hospital’s objectives through direct coordination and commitment to the program’s goals.
• Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc.
• Highly proficient in Microsoft Office particularly Excel, Word, and Outlook. Ability to quickly learn other relevant applications that support management of patient care and assigned responsibilities; and ability to extract necessary information.
   

Additional preferred qualifications:

• Bilingual or multi-lingual skills (beyond that of English) appropriate to the patient population served is a plus.
• Experience with submission of prior authorization requests to third party payors
• Familiarity with 340B drug program and population health concepts
• Knowledge of QS1/NRx, EPIC, Salesforce, Navinet, JIVA

Equal Opportunity Employer/Disabled/Veterans