Pharmacy Advisor at Old Mutual Kenya

Job Description

• The job holder will be responsible for promoting the rational use of medicines and guiding implementation of strategic purchasing for pharmaceuticals to ensure consistent delivery of high-quality cost-effective care, optimum health outcomes and excellent patient experience.

KEY ROLES AND RESPONSIBILITIES

• Promote rational use of medicines – advocate for rational prescribing and dispensing by adhering to standard treatment guidelines
• Strategic purchasing for pharmaceuticals – develop and implement strategic purchasing initiatives for pharmaceuticals
• Preventive care - facilitate integration of preventive and promotive services and provide input during product development and benefit design process
• Member education – continuous education for members on appropriate use of medications, common side effects and drug prices
• Polypharmacy - monitor for unnecessary polypharmacy for appropriate interventions including provider engagement and referral for Medication Therapy Management
• Adherence counselling – monitor patient adherence to medications and counsel those who are non-adherent
• Generic substitution – engage providers and members on the role of generic medications in improving health in a cost-effective way
• Drug Formulary Management – provide input to provider’s formularies to ensure cost-effective use of medicines
• Pharmacy pricelist management - monitoring of pharmacy prices to ensure adherence to Recommended Retail Prices
• Pharmacy benefits management - oversee pharmacy preauthorization through timely and accurate adjudication of pharmacy preauthorization requests
• Drug delivery - support disease management programs by linking members with chronic conditions with preferred pharmacies for drug delivery
• Pharmacy analytics - analysis of prescription patterns for providers and prescription drug use by members and analyze morbidity data to recommend appropriate interventions
• Monitoring errors in pharmacy claims adjudication and preauthorization to inform accuracy in claims management
• Drug utilization review – advise clients and providers on potential adverse drug reactions or drug interactions and counterchecking prescriptions for correctness
• Pharmacy technical support - provide technical support to the clinical team on queries revolving around prescription drugs.
• Keep up to date with current clinical guidelines for common ailments (including NCDs) provided by Ministry of Health and other internationally recognized clinical bodies.
• Pharmaceutical market intelligence - keeping abreast with new developments in the pharmaceutical sector, anticipating potential impacts on the business, and adapting strategy accordingly
• Actively collaborate with specialists, general practitioners, pharmacists, hospitals, patients, and other relevant stakeholders in promoting rational use of medicines

SKILLS AND COMPETENCIES

• Excellent communication, negotiation and interpersonal skills
• Excellent analytical and monitoring skills
• High level of integrity and honesty
• Team player, commitment and ownership
• Empathy and Customer Focus

QUALIFICATIONS, KNOWLEDGE & EXPERIENCE 

• Diploma in Pharmacy                
• At least 3 years’ experience in a busy private hospital or clinic setting
• Prior experience in a health insurance company is highly desirable  
• Solid understanding of insurance principals
• Strong data analytics capability