CSS HEALTH PGY-1 MANAGED CARE RESIDENCY – MEDICATION MANAGEMENT AND DRUG INFORMATIONDear Residency Candidate,
Clinical Support Services (CSS) has been providing clinical program and medication management software and services to managed care organizations (MCOs – both Medicare and Medicaid), prescription benefit managers (PBMs), accountable care organizations (ACOs) and self-insured employers since 2000. Our residency program, founded in 2014, equips residents with managed care and medication management knowledge that can be applied across a variety of pharmacy practice sites. Our residency purpose is to build upon your Doctor of Pharmacy (Pharm.D.) education to develop a managed care clinician with diverse patient care, leadership, and education skills. We provide a variety of longitudinal and modular experiences in medication management, clinical development and integrity, and patient care. Each residency can be individualized and driven towards your personal interests and goals to ensure maximum benefit in the residency year we share together. We are extremely proud of the residency program we have developed and grown over the years, and we are pleased that you are interested in the CSS residency position. To learn more outside of the content provided here, please contact us at any time. Best regards, Stephanie Englert, PharmD CSS Health’s PGY-1 Managed Care Pharmacy Residency Director (and 2014 resident)
PGY1 Managed Care pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) 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.Program Specific Details:
In this environment, PGY-1 training will immerse the resident in the implementation and operation of medication management and clinical programs. Residents will participate in the design and development of clinical programs with a special emphasis on the management and maintenance of drug information reference databases. Finally, residents will be exposed to the sale and marketing of clinical programs across a wide variety of managed care organization types and sizes. The resident will gain an understanding of foundation managed care concepts (e.g. formulary management and benefit design) with a strong focus on direct provision of patient care, clinical program development, and medication management program implementation and administration. Residents will gain experience in providing clinical services at both individual and population levels. CSS residents will develop an especially firm grasp of the pharmacist’s role and function in a Medicare Part D environment. Currently, one (1) position is available for the upcoming residency year.
Core Experiences Longitudinal Experiences
Clinical programs such as Medicare Part D MTM require that clinicians engage patients at high levels (i.e. CMR STAR rate) and produce high quality personal medication records and medication action plans. The pharmacy resident will obtain a foundational understanding of the concepts of patient engagement, motivational interviewing and patient / prescriber consultation and a guided experience for honing engagement, interviewing and consultation skills.
The pharmacy resident will apply lean principals and participate in accreditation assessment activities, root cause analysis and process redesign of incident types and work flow redesign and optimization.
Clinical management and the pharmacy resident will coordinate on topic selection. A phased approach will be used for the resident’s research project. The pharmacy resident will be responsible for topic development, securing IRB approval, and data collection and analysis. Residency project results are presented at AMCP Annual Meeting (or other mutually acceptable meeting) and submitted for publication in JMCP. Residents are also able to enroll in the Teaching Certification Program through D’Youville College School of Pharmacy, located in Buffalo, NY.
DRUG INFORMATION:Drug Information is an 8-week learning experience – there are two phases, each 4 weeks in length.
The pharmacy resident is required to be capable of retrieving medication and disease information from evidence-based sources and formulating a medication management strategy within the context of an evidence-based consensus guideline.
The pharmacy resident is required to be familiar with drug interaction resources and become proficient in communication of drug interactions to health care providers and patients. In addition, the resident will develop an understanding of mapping clinical text into data base format such that it can be queried and used for computerized clinical decision making.
CLINICAL PROGRAM DEVELOPMENT:Clinical Program Development is a 2 quarter (~24 week) week learning experience.
Over the course of this rotation, the resident will be provided with a framework for clinical program development to understand how the program framework is utilized to design and update clinical programs. The pharmacy resident will be responsible for developing the executive summary and clinical elements (e.g., evaluations/interviews, clinical edits, processes) for a clinical program, implementing their program, and reporting outcomes.
FORMULARY/BENEFIT MANAGEMENT:Formulary & Benefit Management is a required, 1 quarter (~12 week) learning experience.
The pharmacy resident is required to become knowledgeable and proficient in formulary and benefit development and management. The resident will identify an area of claims utilizations that deviates from formulary guidance, analyze the extent of deviation and develop a proposal for the client to remediate the deviation from utilization. The resident will participate in the effort to remediate the deviation from formulary guidance.
Current Resident (2019-2020)
SARAH HOPSEKER, PHARMDSchool of Pharmacy: D’Youville College
WHY CHOOSE CSS?
“At CSS Health, I am able to provide patient care on a daily basis and devote time to identifying therapy gaps for patients. I also have the opportunity to improve my communication and teaching skills while receiving my teaching certificate. As a CSS Health resident, I work closely with D’Youville College to assist teaching a medication therapy management class. My experience with patients and students has been rewarding thus far and I look forward to other opportunities throughout my residency.”
Previous Resident (2017-2018)
KALYANN KAUV, PHARMD
School of Pharmacy: Virginia Commonwealth University Post-Residency Position: Medicaid Clinical Pharmacist