Clinical Pharmacist

This is a fully remote position, open to applicants in New York.

📋 Description

• Assist in addressing care gaps through direct outreach to providers and members, collaboration with provider engagement, and utilizing pharmacy network resources.

• Ensure that recommendations align with the most current guidelines or are supported by clinical literature.

• Offer clinical pharmacy assistance to pharmacy technicians who are reaching out to members regarding medication adherence.

• Address barriers to adherence and employ motivational interviewing techniques to enhance member health outcomes.

• Work together with Marketing, IT, and Enterprise Analytics to develop strategic digital communication methods for member outreach.

• Identify and address same-day member complaints in accordance with established policies and procedures.

• Manage and uphold compliance with both State and Federal regulations.

• Mentor Pharmacy Residents and Students.

• Ensure that clinical criteria meet CMS and NYSDOH standards.

• Conduct research on drug information to maintain an up-to-date understanding of medications and disease states.

• Analyze monthly reports and provide insights on trends, efficiency, and innovative practices.

• Assist in conducting regulatory and compliance audits across all plans.

• Perform additional tasks as assigned or required.

⛳️ Requirements

• Doctor of Pharmacy degree from an accredited pharmacy school.

• Licensed Pharmacist, maintaining a good standing state license.

• Professional experience involving clear, concise, and grammatically correct written and verbal clinical communication.

• Familiarity with specialty pharmaceuticals and billing practices related to medical and pharmacy benefits.

• Bilingual in English and one or more additional languages such as Spanish, Mandarin, or Cantonese may be necessary based on business demands.

• Ability to collaborate effectively within a team and demonstrate team player qualities.

• Proven critical thinking and problem-solving abilities.

• Enthusiasm for continuous learning, promoting the pharmacy profession, and a desire to develop skills in a vibrant environment with diverse opportunities.

• Understanding of the regulations set forth by the Centers for Medicare and Medicaid Services, including but not limited to National and Local Coverage Determinations.

• Capability to lead both large and small meetings effectively.

• Proficient in PC skills with Microsoft Outlook, Word, PowerPoint (for creating presentations and slides), and Excel (including Pivot tables).

• Licensed pharmacist in good standing.

🏝️ Benefits

• Medical, dental, and vision insurance.

• Incentive and recognition programs.

• Life insurance coverage.

• 401k contributions.

• Competitive salary and comprehensive benefits package.