Managed Care - 24
Goal:
To prepare the student with a knowledge base and problem solving skills relating to the provision of patient care in a managed care environment.Rotation Specific Learning Objectives:
Upon completion of the rotation, the student shall be able to:Clinical Management
1. Describe the concept of managed care particularly as it applies to pharmacy.Fiscal Management2. Demonstrate a working knowledge of reimbursement systems and how they will affect the future of managed care pharmacy.
3. Integrate didactic concepts in health systems, pharmacy management, jurisprudence and therapeutics with clinical experience to make appropriate recommendations in improving patient outcomes.
4. Demonstrate working pharmacotherapeutic knowledge and skills.
5. Demonstrate a working knowledge of formulary development, evaluation and refinement.
6. Conduct a prospective, retrospective, and concurrent drug use evaluation (DUE).
7. Independently gather and assess drug utilization data in order to recommend monitoring parameters required for proper drug utilization review.
8. Describe the role of the pharmacist in the following managed care settings: hospital, community, third party payer organization, clinic.
9. Effectively communicate with other members of the health care services team and perform as an integral member.
10. Demonstrate a sense of personal/professional responsibility for improving patient outcomes through managed care.
11. Perform pharmacotherapeutic case management.
12. Perform pharmacoeconomic assessment that includes health outcome, cost/benefit, and cost/effectiveness.
13. Demonstrate working knowledge of Pharmacy and Therapeutic Committee responsibilities.
14. Discuss the development and refinement of policies and procedures.
15. Identify needs, prepare and present topics for the purpose of education within the practice setting.
16. Identify methods of implementing, maintaining and evaluating pharmacy patient care services.
17. Communicate appropriate responses concerning drug selection and dosage regimens to health care practitioners in a clear and logical fashion.
18. Utilize medical information sources, and in conjunction with the available clinical information, formulate comprehensive, accurate, organized and nonbiased responses to questions pertaining to drug therapy.
19. Demonstrate working knowledge of the use of traditional (textbooks, journals) and nontraditional reference sources (microfiche systems, compact disc, electronic data bases, bulletin boards) for researching literature.
20. Demonstrate a working knowledge of the budgeting, controlling, purchasing, reporting and evaluating processes.Human Resources Management21. Describe contract development and negotiation.
22. Discuss forecasting and planning using various management techniques.
23. Compare and contrast various clinical management reimbursement systems (i.e., on-line, real time, pharmacy drugs claim transaction).
24. Demonstrate a working knowledge of state and federal laws impacting pharmacy practice.
25. Discuss the need for and uses of a policy and procedure manual.26. Describe principles and concepts of personnel matters relating to staffing, recruitment, supervision, personnel evaluation, time management and collective bargaining.
27. Perform formal and informal inservice education to encourage staff development and life long learning.
28. Demonstrate a working knowledge of continuous quality improvement (CQI) and total quality management (TQM).
29. Demonstrate a working knowledge of state and federal laws pertaining to personnel.