Clinical Pharmacist

🔥 0 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $103.4k - $149.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

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Healthfirst

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1993

🛡️ Insurance

🏥 Healthcare

⚕️ Healthcare Insurance

Insurance • Healthcare • Healthcare Insurance

Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.

📋 Description

• Support initiatives to resolve gaps in care through direct provider and member outreach, collaboration with provider engagement, and leveraging pharmacy network capabilities • Ensure recommendations are consistent with the latest guidelines or supported by clinical compendia • Provide clinical pharmacy support to pharmacy technicians conducting member outreaches regarding medication adherence • Resolve barriers to adherence and use motivational interviewing to improve member health • Collaborate with Marketing, IT, and Enterprise Analytics on strategic digital communication channels for member outreach • Identify and resolve same-day member grievances according to policies and procedures • Oversee and maintain compliance with State and Federal agencies • Precept Pharmacy Residents and Students • Ensure clinical criteria comply with CMS and NYSDOH requirements • Research drug information to maintain drug knowledge and disease-state understanding • Review monthly reports and provide feedback on trends, efficiency, and innovation • Assist in regulatory and compliance audits for all plans • Perform 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 • 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) • Licensed pharmacist in good standing

🏖️ Benefits

• Medical, dental and vision coverage • Incentive and recognition programs • Life insurance • 401k contributions • Competitive compensation and benefits package