Clinical Pharmacist

12 hours ago


New York, New York, United States Health First Full time
Job Summary:

As a Clinical Pharmacist - Care Coordination Specialist at Health First, you will play a vital role in supporting initiatives to resolve gaps in care through direct provider and member outreach, collaboration with provider engagement, and leveraging our pharmacy network capabilities.

Key Responsibilities:

Ensure that all recommendations are consistent with the latest guidelines or otherwise supported by the clinical compendia

Provide clinical pharmacy support to pharmacy technicians as they conduct outreaches to members regarding medication adherence, resolve existing barriers to adherence, and use motivational interviewing to improve the health of our members

Collaborate internally with Marketing, IT, and Enterprise Analytics to assist with the creation of strategic digital communication channels for member outreach

Identify and resolve same-day grievances reported by members in a timely manner consistent with our policies and procedures

Oversee and maintain compliance with all State and Federal agencies

Precept Pharmacy Residents and Students

Ensure all clinical criteria is in compliance with Center of Medicare and Medicaid Services (CMS) and the New York State Department of Health (NYSDOH)

Research drug information to maintain drug knowledge and disease state understanding

Review monthly reports and provide feedback on trends, ideas for efficiency, and innovation

Additional duties as assigned or required

Requirements:

Pharmacy degree from an accredited school of pharmacy

Registered Pharmacist, with a state license in good standing

Work experience requiring written and verbal clinical communication that is clear, concise, grammatically correct, and professional

Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits

Preferred Qualifications:

Bilingual in English and one or more language(s): Spanish, Mandarin, Cantonese may be required based on business needs

Ability to work well in a team environment and be a team player

Demonstrated critical thinking and problem-solving skills

Passion for learning, promoting the profession of pharmacy, and interest in growing skills in a dynamic environment with various opportunities

Knowledge of regulations of the Centers for Medicare and Medicaid Services including but not limited to National and Local Coverage Determinations

Ability to lead large and small working meetings

PC Skills with Microsoft Outlook, Word, PowerPoint (creating presentations and slides), and Excel (Pivot tables)

Compliance & Regulatory Responsibilities:

Assists in regulatory and compliance audits for all plans. Ensure all activities are conducted in compliance with regulations.

License/Certification:

Licensed pharmacist in good standing

Health First is an equal opportunity employer.
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