The Clinical Pharmacist is responsible for efforts to support quality measures for both our Essential Plan and Medicare populations. The Clinical Pharmacist conducts provider and member outreach to address gaps in care measures, support medication adherence initiatives, and assist with strategies to improve quality measures, all while maintaining compliance with all Federal and State agencies. This is a dynamic position requiring the Clinical Pharmacist to stay current with literature, evidence-based medicine, and trends in medicine.

　　Duties & Responsibilities:

　　Support initiatives to resolve gaps in care through direct provider and member outreach, collaboration with provider engagement, and leveraging our pharmacy network capabilities

　　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 med 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

　　Minimum Qualifications:

　　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

　　WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

　　If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

　　EEO Law Poster and Supplement (http://www.dol.gov/agencies/ofccp/posters)

　　All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

　　Hiring Range*:

　　Greater New York City Area (NY, NJ, CT residents): $100,900 - $145,775

　　All Other Locations (within approved locations): $86,500 - $128,690

　　As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

　　In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

　　*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.