Harvard Pilgrim Health Care
93 Worcester Street
Wellesly, MA 02481
Mark L. Thomas, RPh
Senior Clinical Pharmacy Specialist
The Preceptor is licensed in Massachusetts.
Description of the Activities in which the Student Pharmacist will be Involved
Harvard Pilgrim Health Care is a leader in the provision of managed health care services. Harvard Pilgrim’s passion is to make health care work better for the people and communities we serve. We collaborate with consumers, doctors, employers and brokers to offer innovative, customized solutions, delivered with exceptional service, all with the goal of improving value and quality across the health care system. Our mission is to improve the quality and value of health care for the people and the communities we serve, to be consistently recognized as a leading health services company in each of our markets. At Harvard Pilgrim, we believe that greatness is built from the inside out and comes from the values that we all practice and share. Harvard Pilgrim initiates many projects related to the improvement of health and wellness in the care of its members. These projects are targeted at members of all ages and diagnoses.
The student rotation will relate to a variety of projects involving
• Pharmacy Benefit Management Administration
• Pharmacy Contracting
• Drug Policy Research and Development
• Drug Evaluation and Utilization Review
• Managed Care
• Legal Requirements and Regulatory Provisions
• Disease Management, Wellness, and Healthcare Improvement
Projects will allow the student to participate in and learn about the administration of a prescription drug benefit for Commercial, Part D and Public Healthcare Exchanges.
Activities will take place on site in the HPHC corporate office located in Wellesley, MA. Hours of operation are Monday through Friday from 8:30am to 5:00pm. Projects may involve direct contact with HPHC members or may involve research, design and implementation of pharmacy initiatives. The student will be precepted by a Registered Pharmacist and will participate in multidisciplinary teams that include Physicians, Pharmacists, program consultants and business analysts. During the rotation, pharmacy students will divide their time between Clinical Pharmacy Operations and Pharmacy Contracting.
Responsibilities may include:
• Participation on project lead teams: discussion, planning, strategy deployment.
• Individual research on specific drugs, diseases, formulary designs, coverage policies.
• Assisting with the development and implementation of Drug Utilization Management programs.
• Reviewing Prior Authorization requests against defined clinical criteria.
• Review of member Appeals, Benefit and Formulary Exceptions, Reconsiderations.
• Reviewing Pharmacy claims and medical records for situations of poly-pharmacy, duplication of therapy, under and over-utilization, compliance, medication adherence, fraud, waste or abuse.
• Responding to drug information requests from Operations Coordinators and Clinical Pharmacy Specialists.
• Meet with Medical Science Liaisons and Clinical Specialists to review study results and determine a drug’s formulary placement.
• Meet with national account managers from the pharmaceutical industry as an introduction to contracting and negotiations.
• Review current literature for information related to new drugs therapies and updates to treatment guidelines.
• Attend bimonthly Clinical Staff meetings and observe decision-making processes of formulary management.
• Attend bimonthly Operations meetings and observe decision-making process of the support team coordinators.
• Attendance at PBM account management meetings.
• Special projects as directed by Pharmacist preceptor or other Clinical Pharmacy Specialists.
The experience is structured as a 6-week rotation. Site will accept non-traditonal students if approved by the University.
Site can accommodate student pharmacists throughout the year.
Site does not offer an IPPE.
Site can accomodate one to two (1-2) student pharmacists per rotation block.
State and School/College Preference
Site is accepting student pharmacists from The Massachusetts College of Pharmacy or Northeastern University.
Site does not provide housing or housing assistance.
Student Pharmacist Prerequisites Prior to the Rotation Start
Site does not require prerequisites.
Affiliation Agreement Required by Site
Site does require the school/college to sign an affiliation agreement.