Pharmacy Professionals Discuss Working in Managed Care

Pharmacy students and potential career-changers received tips on how to get into the managed care pharmacy side of the profession during a session at the AMCP Nexus conference at the Gaylord National Convention Center in National Harbor, Maryland, on October 12, 2022. During the discussion titled “Pathways to Managed Care Pharmacy,” the 3 panelists, all seasoned managed care pharmacy professionals, shared their experiences and offered advice for those exploring alternate career paths in managed care.

Specifically, the panelists discuss how managed care pharmacists have transcended traditional roles to become vital members of health care teams. In the managed care arena, pharmacists are provided with opportunities to work in various innovative and specialized roles that improve quality, optimize patient outcomes, and reduce health care costs, the panelists explained.

However, it remains essential that managed care pharmacists work closely and build strong relationships with community pharmacies and employer groups, explained panelist Alexandra Lin, PharmD, manager of pharmacy clinical programs and customer support, clinical services, at Blue Cross Blue Shield of Michigan in Detroit.

This means working closely with different stakeholders within the whole health care continuum, Lin said. Specific roles in managed care pharmacy could be in the clinical, education, formulary, medication therapy management, and opioid use disorder areas, among others, according to the panelists, while it is evolving into digital therapeutics and other technologies, as well as more individualized care.

It is important to figure out “what makes you tick; what makes you passionate about pharmacy,” when deciding what path to take, according to panelist Stephanie Englert, PharmD, BCGP, director of clinical development at CSS Health in Buffalo, New York.

The panelists said that pharmacy students who are interested in managed care should seek related internships or residencies.

These opportunities are competitive, so students should make sure they are well-rounded by showing involvement in school, taking on leadership roles, and perhaps working in a pharmacy, all while maintaining good grades, according to panelist Erika Kaplan, PharmD, BCACP, pharmacist - clinical outcomes and therapeutic optimization, at PerformRx in Philadelphia, Pennsylvania.

“You’re not just doing 1 thing as a managed care pharmacist but juggling a lot of things,” Kaplan said, adding that though an internship in managed care is not necessary, it is important to “demonstrate you have what it takes.”

Lin recommended that students participate in the AMCP Foundation National Student Pharmacist Pharmacy & Therapeutics (P&T) Competition, an annual team event for pharmacy students. Participating in the AMCP P&T competition gives you a leg-up, Lin explained. However, there is a difference between those who participate in the P&T competition and those who do not in terms of how enthusiastic students are.

Additionally, Lin recommended students seek out mentors during their time in pharmacy school.

“Treat your rotations like a 6-week interview,” Englert said. “You want to grow those relationships; you want to network.”

One of the things that surprised her about managed care pharmacy was the relationships her preceptors have, Lin said.

“Always make sure you’re putting your best foot forward in whatever rotation you’re in; you never know how people are connected,” she said. “Managed care pharmacy is a super, super, super small world.”

Reference

Englert S, Kaplan E, Lin A. Pathways to managed care. Presented at: AMCP Nexus; Gaylord National Convention Center in National Harbor, Maryland: October 12, 2022.