Managed Care Pharmacy Concentration | PCOM School of Pharmacy
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Managed Care Concentration

Doctor of Pharmacy (PharmD)

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Managed Care Pharmacy Concentration 
Become a Managed Care Pharmacist

The Managed Care Pharmacy Concentration includes six (6) credit hours in didactic elective coursework in relevant topics including population-based care, with experiential training focusing on managed care pharmacy. Graduates can also pursue PGY-1 residency programs specializing in managed care pharmacy.

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What is a managed care pharmacist?

Managed care pharmacists evaluate and develop plans to optimize individual- and population-based health outcomes while balancing available resources. Managed care pharmacists work for pharmacy benefit management companies, health insurance and health plan companies, accountable care and managed care pharmacy organizations, such as Aetna, Cigna and Anthem.

What is managed care pharmacy?

Pharmacists working in managed care pharmacy assist in the development of pharmacy benefits for health plans, design and implement clinical programs based on the latest clinical evidence, manage quality and cost-effectiveness of treatments and help ensure patient safety through processes designed to identify unsafe medications or drug interactions.

Which courses will I take for the Managed Care Pharmacy Concentration?

The Managed Care Pharmacy Concentration requires the completion of six (6) credit hours of elective coursework. Students will complete two, one-credit managed care courses per term in the third year (six courses for a total of six credits). Current course offerings are listed below and are subject to change. Consult the course catalog for additional information.

Health Care Informatics

This course will advance students’ understanding of the specific role of clinical informatics in patient safety and health outcomes with an emphasis on pharmacy-driven medication use processes in health systems. Students will develop the knowledge and skills to assume responsibility for identifying, accessing, retrieving, creating and exchanging relevant patient and health information to ensure safe and effective patient care throughout the medication use process. Attention is given to the roles and responsibilities of the pharmacy informatics in information technology and automation to improve accessibility of information from practice advancement. This course may incorporate lectures, readings assignments, participatory discussions, homework assignments and student presentations.

Drug Pricing, Contracts and Marketing

In the current information age, pharmaceutical marketing is vastly different given the increasing presence of the internet and social media, company consolidation, and regulatory changes throughout the last decade. Not only have the number of blockbuster medications produced by Pharma decreased, but so has the presence of directed sales representatives in physician offices. Therefore, pharmaceutical and healthcare industry marketers must work harder and smarter to maximize every product’s or service’s potential. This course will examine the current pharmaceutical marketing environment from both an academic and practical perspective and give students the opportunity to gain a deeper understanding of the business and regulatory aspects of the pharmaceutical manufacturing industry.

Pharmacoeconomic Modeling

This hands-on course provides an overview of the basic economic and statistical modeling techniques in health care. Specifically, this course will introduce techniques of how to manage and analyze a healthcare database for conducting any economic modeling in health care. This course may incorporate lectures, readings assignments, homework assignments and student presentations to accomplish these goals.

Leadership in MCO, PCMHs, and ACOs

This course prepares students with a deeper understanding of the needs and challenges of contemporary managed care and team-based healthcare delivery models. Pharmacy and pharmacist roles are growing rapidly, requiring pharmacist leaders in advancing value-based healthcare outcomes and maximizing patient care. Special emphasis will be placed on providing practical and real-world leadership strategies needed to interact effectively as a managed care team member.

Pharmacovigilance

This course presents students with a systems approach to post-market monitoring of safe and effective use of medications. Students will be exposed to adverse-drug reaction reporting systems and regulatory affairs for pharmaceutical manufacturers, payors, and pharmacy benefit managers.

Entrepreneurship: Community Pharmacy Management and Performance

This course* is designed to provide the student with the necessary information to become a community pharmacy owner either through the establishment of a new pharmacy or the purchase of an existing pharmacy. The student will learn layout and design, location analysis, evaluation of third-party plans, and promotional offerings, as well as the financial aspects of the development, implementation and performance of value-added clinical services in the community setting.

*May also satisfy Ambulatory Care Concentration.

Advanced Health Systems Management, Outcomes and Services

This course* provides the student with knowledge and skills for managing population health outcomes in healthcare systems. The focus is on understanding the role of costs in healthcare delivery and the balance between optimizing healthcare costs and achieving outcomes. Special emphasis will be given to the application of health services research data to the quality of care from the perspective of a population-health manager.

*May also satisfy Acute or Ambulatory Care Concentration.

Formulary Management and Drug Utilization Review

This course delves into the formulary management systems used at health plans, PBMs and managed care organizations. Special attention is given to understanding drug use evaluation programs in reviewing patient data for safety and appropriate medication use. The course will explore the process of conducting DURs and how to use population health information to inform drug therapy recommendations for health systems.

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