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

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7. Discuss the concept of utilization management and provide functional definitions of key elements associated with drug-related utilization management (such as prior authorization, step therapy, and quantity limits). 8. Discuss general concepts associated with the benefit structure of a health plan, including co-pay vs. co-insurance, premium vs. deductible and maximum out-of-pocket costs. 9. Identify the major factors influencing drug costs for a managed care organization (e.g., pharmacy costs, drug pricing methodologies, contracts/rebates, discounts). 10. Identify and explain the steps involved in the drug-approval process in the U.S. 11. Explain the purpose and function of pharmacy benefit management programs. 12. Discuss the principles of patient-centered care management programs. 13. Discuss the principles of quality management 14. Explain the role of quality organizations in ensuring quality in the managed care setting. 15. Identify and explain the major roles of the pharmacist in population-based provision of care (as distinguished from direct patient care). 16. Explain the term specialty pharmaceuticals, give examples of such products, and describe generally how they are procured, stored and dispensed to patients. 17. Identify several major factors that contribute to drug-related fraud and abuse. 18. Identify several major factors that contribute to drug waste. 19. Discuss the requirements for patient confidentiality as provided for under the 1996 Health Insurance Portability and Accountability Act (HIPAA) and professional practice guidelines. Psychomotor domain 20. Demonstrate strong clinical skills. 21. Communicate effectively, both orally in writing, in a manner appropriate for the intended audience (e.g., patient, health care provider, plan sponsor). 22. Apply critical-thinking and problem-solving skills. 23. Demonstrate strong computer skills and apply those skills in analyses, presentations and communications. 24. Function as a productive team member. 25. Advocate on behalf of the appropriate use of medications and needs of patients. 26. Develop a variety of drug-related reports, monographs, reviews, and policies, using drug literature evaluation skills. 27. Develop educational materials and correspondences for patients and caregivers (at the appropriate level of understanding). 28. Conduct literature searches on existing marketed drug products and those in the pipeline. 29. Evaluate appropriateness of clinical trials of medications, including validation of trial design and assessment of data credibility. 30. Create and maintain effective relationships with others, based on an understanding of the needs of key stakeholders. 31. Demonstrate effective medication therapy management skills. 32. Apply major clinical practice guidelines in making therapeutic recommendations for individual patients. 33. Demonstrate expertise in formulating, interpreting, and evaluating clinical medication criteria. 4
34. Conduct medication utilization evaluations. 35. Identify quality/outcome indicators that could be used in evaluating a specific pharmacy service or program. 36. Evaluate medication-use patterns in a specified patient population. Affective domain 37. Respect for employer, colleagues and patients 38. Honesty and integrity 39. Appropriate work ethic 40. Personal responsibility and accountability 41. Professional dress 42. Respect for patient confidentiality and privacy 43. Honoring promises (keeping commitments) 44. Punctuality We believe the findings of this Task Force have important implications both for the American Association of Colleges of Pharmacy (AACP) and the Accreditation Council for Pharmacy Education (ACPE), and AMCP stands ready to work with both organizations to ensure that pharmacy students receive the necessary education and training to practice upon graduation at an entry level in the managed care environment. AMCP remains dedicated to providing education and training opportunities in the areas of postgraduate residency training and continuing professional development, to ensure a continuing supply of qualified manpower in managed care pharmacy. We seek to work closely with the academic community in discharging our responsibilities in these areas, as well as in continually assessing the entry-level competencies required of new graduates. 5
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Entry-level Competencies Needed for Managed Care Pharmacy ...

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