Evolent Health’s mission is to change the health of the nation by changing the way health care is delivered. With a provider heritage and over 20 years of health plan administration experience, we partner with leading provider organizations in more than 30 U.S. health care markets to achieve superior clinical and financial results in value-based care.
This program provides comprehensive systematic training to prepare a pharmacist for future clinical, business, operations and/or leadership roles in managed care practice, providing both clinical and health plan/pharmacy benefit management experiences.
The resident will have opportunities to develop evidence-based clinical decision making, project management, analytical and leadership skills. In addition, our affiliation with Shenandoah University School of Pharmacy provides an opportunity to earn a teaching certificate and gain experience in academia and student precepting.
The purpose of a PGY1 Managed Care Pharmacy Residency program is to build upon the Doctor of Pharmacy (PharmD) education and outcomes to develop managed care pharmacist clinicians with diverse patient care, leadership and education skills who are eligible for board certification and postgraduate year two (PGY2) pharmacy residency training. A managed care residency will provide systematic training of pharmacists to achieve professional competence in the delivery of patient care and managed care pharmacy practice.
Provide direct patient care through Population Health/Care Management programs
Develop and participate in Interdepartmental Clinical Initiatives
Perform Drug Utilization Reviews (DURs)
Formulary and Utilization Management
Differentiate regulations, needs and nuances among different lines of business (Medicare, Medicaid, Commercial and Exchange) and regional management tactics
Develop drug monographs and medical policies that govern Utilization Management (UM) practice
Participate in Coverage Determination case review
Assess specific population needs of our multiple partner plans
Participate in Specialty Pharmacy management and drug use evaluation
Gain exposure and understanding of health plan accreditation processes
Develop and implement strategies to address/improve the quality of care as measured by Centers for Medicare and Medicaid Services (CMS) Star Ratings and National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS)
Clinical Pharmacy Services – focused and longitudinal
Utilization Management – focused and longitudinal
Analytics/Clinical Informatics – focused
Product Management – focused
Strategy and Plan Performance – focused
Quality/Compliance – focused
Pharmacy Operations – focused
Professional Practice – longitudinal
Research – longitudinal
Elective – focused
Teaching and Learning – longitudinal (optional)
PharmD degree from an ACPE-accredited college of pharmacy
Active pharmacist license or eligibility for licensure in the state of Virginia and eligibility to obtain licensure in one additional state at Evolent’s discretion
Letter of intent summarizing candidate’s interest in managed care
Current curriculum vitae
Three letters of recommendation
Copy of official pharmacy school transcripts
Preliminary phone/Skype interview followed by on-site interview with oral presentation for select candidates
Excellent written and verbal communication skills
About Evolent Health PGY1 Managed Care Residency
Recruiting for affiliated residency programs.
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