Tag: Pharmacy

Price: $180.95 – $93.21
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Publisher ‏ : ‎ Jones & Bartlett Learning; 2nd edition (December 25, 2008)
Language ‏ : ‎ English
Hardcover ‏ : ‎ 633 pages
ISBN-10 ‏ : ‎ 0763732400
ISBN-13 ‏ : ‎ 978-0763732400
Item Weight ‏ : ‎ 2.55 pounds
Dimensions ‏ : ‎ 7 x 1.5 x 9.1 inches

Managed Care Pharmacy Practice: What You Need to Know

Managed care pharmacy practice is a critical component of the healthcare system, ensuring that patients receive safe, effective, and cost-effective medication therapy. As a managed care pharmacist, you play a key role in managing medication use, promoting medication adherence, and optimizing patient outcomes.

In this post, we will dive into what managed care pharmacy practice entails, the key responsibilities of a managed care pharmacist, and how this practice area is evolving to meet the changing needs of patients and healthcare providers.

Key Responsibilities of a Managed Care Pharmacist:

1. Formulary Management: Managed care pharmacists are responsible for developing and maintaining the formulary, which is a list of medications that are covered by a specific health plan. They work closely with physicians and other healthcare providers to ensure that the formulary is evidence-based, cost-effective, and meets the needs of the patient population.

2. Prior Authorization: Managed care pharmacists review medication requests that require prior authorization to determine if they meet the criteria for coverage. They may also provide clinical guidance to healthcare providers to ensure that the most appropriate medication is prescribed.

3. Medication Therapy Management (MTM): Managed care pharmacists provide MTM services to help patients optimize their medication therapy, improve medication adherence, and prevent medication-related problems. This may include medication reviews, patient education, and monitoring for drug interactions or side effects.

4. Cost Containment: Managed care pharmacists work to contain costs by promoting the use of generic medications, negotiating drug discounts with manufacturers, and implementing medication utilization management strategies.

5. Quality Improvement: Managed care pharmacists play a key role in quality improvement initiatives, such as medication safety programs, medication reconciliation, and monitoring of medication-related outcomes.

How Managed Care Pharmacy Practice is Evolving:

Managed care pharmacy practice is evolving to meet the changing needs of patients and healthcare providers. With the increasing focus on value-based care, managed care pharmacists are playing a more prominent role in care coordination, population health management, and value-based reimbursement models.

Technology is also playing a significant role in shaping managed care pharmacy practice, with the use of electronic health records, telehealth services, and mobile health applications to improve medication management and patient outcomes.

As the healthcare landscape continues to evolve, managed care pharmacy practice will remain a critical component of the healthcare system, ensuring that patients receive safe, effective, and cost-effective medication therapy. If you are interested in a career in managed care pharmacy, consider pursuing additional training or certification in this specialized practice area to enhance your skills and expertise.
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