Multiple Positions Available - Starting January or February 2025 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