The posting
Job Description
Overview
We are looking for team members who are passionate about challenging and significant work for the good of every patient. We are searching for individuals who are compassionate, serve with a purpose, are dedicated to supporting their team, and who seek excellence every day.
Sound like a perfect match? Apply now - we can't wait to hear from you!
Why Join IU Health?
As Indiana’s largest and most comprehensive healthcare system, and the number 1 ranked healthcare system in Indiana, we offer:
- 401(K) retirement savings with employer match
- Tuition reimbursement
- Student loan forgiveness - Government program that may allow qualifying participants to have the remainder of their student loan balance forgiven (after a set amount of time and specific qualifications have been met).
- Employee Assistance Program – Counseling at no cost to you
- Healthy Results - Participation in our team member wellness programs award points that contribute toward a biweekly financial incentive in your paycheck! The more you participate, the more you earn!
Description:
The Clinical Pharmacist serves within IU Health's centralized system-level infusion access model and functions as a clinical liaison between ordering providers, infusion operations, and revenue cycle teams.
The Clinical Pharmacist supports timely patient access to infusion therapies through clinical review, medical necessity assessment, payer policy interpretation, clinical documentation support, site-of-care optimization, and referral management. The position plays a critical role in helping patients navigate payer requirements while supporting providers and financial clearance teams in obtaining prior authorization approvals for infusion therapies.
The Clinical Pharmacist partners closely with physicians, advanced practice providers (APPs), nurses, financial clearance specialists, managed care teams, and infusion program leaders across the health system to ensure patients receive the right therapy in the right setting at the right time.
As a member of a newly established system team, this individual must be comfortable working in an evolving environment and helping design, refine, and optimize workflows, processes, and best practices across multiple infusion service lines.
The Clinical Pharmacist operates at the intersection of clinical pharmacy, infusion strategy, payer policy, and operational excellence, creating meaningful impact without traditional dispensing responsibilities.
Key Responsibilities
Clinical Review and Medical Necessity Support
- Review infusion referrals and treatment plans to assess completeness, clinical appropriateness, and alignment with payer requirements.
- Evaluate supporting clinical documentation against payer medical policies, evidence-based guidelines, and therapy-specific coverage criteria.
- Identify gaps in documentation and collaborate with providers and clinical staff to obtain necessary information.
- Assist providers in developing medical necessity documentation, letters of medical necessity, and clinical justification materials.
- Support appeal and peer-to-peer preparation activities as appropriate.
- Maintain expertise in infusion-related payer requirements, coverage policies, and clinical guideline updates.
Prior Authorization and Access Support
- Collaborate closely with financial clearance and authorization teams to provide clinical information required for payer review and serve as a centralized clinical resource.
- Assist in identifying reasons for authorization denials and opportunities for successful resubmission or appeal.
- Support initiatives aimed at reducing authorization turnaround times and preventing avoidable denials.
- Interpret and communicate payer requirements to providers, clinic staff, and operational teams.
Site-of-Care Optimization
- Evaluate payer site-of-care requirements and restrictions for infusion therapies.
- Assist providers and operational teams in identifying clinically appropriate and financially sustainable sites of care.
- Support transitions between hospital outpatient departments, ambulatory infusion centers, home infusion services, and other alternative infusion settings when appropriate.
- Maintain awareness of evolving payer policies that impact infusion location, reimbursement, and utilization management.
Clinical Referral Management
- Review incoming referrals to ensure accurate therapy selection, diagnosis documentation, and supporting clinical information.
- Coordinate with providers, nursing teams, and operational partners to facilitate timely progression of referrals through the access pathway.
- Assist in developing and standardizing referral workflows across the health system.
- Support timely patient access while minimizing administrative burden on clinical teams.
Provider and Team Collaboration
- Serve as a trusted pharmacy resource for physicians, advanced practice providers, nurses, and revenue cycle partners.
- Communicate clinical requirements and payer expectations clearly and effectively.
- Facilitate problem-solving for complex patient access cases.
- Build collaborative relationships with stakeholders across multiple specialties and geographic locations.
- Participate in multidisciplinary discussions regarding access barriers and process improvement opportunities.
Program Development and Optimization
- Participate in the creation and refinement of infusion medication access workflows, policies, and operational standards.
- Identify opportunities to improve patient access, reduce delays, and enhance process efficiency.
- Contribute to development of payer intelligence resources, clinical documentation tools, and infusion access playbooks.
- Assist with tracking operational, financial, and patient access performance metrics.
- Support ongoing growth and maturation of the infusion medical access program as a centralized enterprise service.
Minimum Qualifications
- Doctor of Pharmacy (PharmD) degree from an accredited college or school of pharmacy.
- Current pharmacist licensure in the State of Indiana or eligibility for Indiana licensure.
- Five (5) years of clinical pharmacy experience or completion of an accredited PGY1 Pharmacy Residency.
- Demonstrated knowledge of evidence-based medicine and clinical guideline evaluation.
- Ability to independently assess clinical information and apply sound clinical judgment.
- Excellent written, verbal, and interpersonal communication skills.
- Strong organizational and problem-solving abilities.
- Ability to effectively collaborate with physicians, APPs, nurses, and cross-functional operational teams.
- Proficiency with electronic health records and clinical documentation systems.
Preferred Qualifications
- Three (3) or more years of infusion-related pharmacy experience, including ambulatory infusion, specialty pharmacy, home infusion, infusion operations, infusion reimbursement, medication access, or infusion clinical services … OR…
- Board certification (BCPS, BCACP, CSP, or other relevant specialty certification).
Success Characteristics
The ideal candidate will demonstrate:
- Strong clinical judgment and critical thinking skills.
- Ability to analyze complex clinical and payer-related information and translate findings into actionable recommendations.
- Comfort interacting directly with physicians, APPs, nurses, financial clearance specialists, and operational leaders.
- Exceptional communication and relationship-building abilities.
- Intellectual curiosity and a commitment to continuous learning regarding evolving payer requirements and infusion therapies.
- Adaptability and resilience within a newly formed and rapidly evolving team structure.
- A process-improvement mindset and willingness to help build new workflows and operating models.
- Passion for improving patient access to medically necessary therapies.
- Commitment to collaboration, innovation, and enterprise-wide health system improvement.
Schedule and Work Location
Schedule
- Full-time
- Monday through Friday, day shift
- No regularly anticipated weekends, holidays, or on-call responsibilities
Work Location
- Hybrid position; team members are expected to work on-site a minimum of three (3) days per week
- Flexible work location within Indiana; may be based at the IU Health Integrated Service Center (ISC) in Plainfield, Indiana, or at other IU Health facilities across the state
Requirements:
- Requires Doctor of Pharmacy (PharmD) or Bachelor's of Science in Pharmacy prior to 2006.
- Successful completion of an ASHP accredited PGY1 or PGY2 residency may be required.
- Requires 5-7 years of relevant experience.
- Requires current Indiana Pharmacist license or eligibility for Indiana licensure as a Pharmacist.
- Board certification or other specialized training may be required.
- Basic Life Support certification through the American Heart Association (AHA) may be required.
- Requires all essential functions of Pharmacist and Pharmacist-Intermediate job descriptions.
- May require travel to IU Health facilities.
- May require weekend rotations.
