Entry-level Competencies Needed for Managed Care Pharmacy ...

prescription drugs and related services in a
managed care organization
11 Explain the role of quality organizations and 53.0 3.72
accreditation agencies in ensuring quality of
managed care operations (including the quality
of patient care and the quality of pharmaceutical
products and devices purchased by the
organization)
12 Identify and describe the steps involved in the 75.5 3.71
drug distribution process, from the
manufacturer to the ultimate consumer
(including physicians, nurses, pharmacists and
patients) and the prescription reimbursement
flow from managed care provider to pharmacy
and the patient
13 Explain how state and federal laws and
56.7 3.82
regulations are integrated into the operation of a
managed care organization
14 Identify and explain the steps involved in the 90.6 3.70
drug-approval process in the U.S.
15 Explain the general structure and functions of 52.6 3.52
alternative health-care delivery options,
including integrated health systems, accountable
care organizations, and patient-centered medical
homes
16 Explain the purpose and function of pharmacy 87.0 4.30
benefit management programs
17 Discuss the principles of disease management 88.7 4.18
programs/care management programs
18 Discuss the principles of quality management 72.5 3.96
19 Identify and explain the major roles of the
75.5 4.00
pharmacist in population-based provision of
care (as distinguished from direct patient care)
20 Explain the term specialty pharmaceuticals, 88.6 4.14
give examples of such products, and describe
generally how they are procured, stored and
dispensed to patients
21 Identify several major factors that contribute to 82.5 3.89
drug-related fraud and abuse
22 Identify several major factors that contribute to 84.5 3.89
drug waste
23 Discuss the requirements for patient
confidentiality as provided for under HIPAA
and professional practice standards
94.7 4.52
Skills (psychomotor domain)
44