Clinical Pharmacist (Garden City, NY)

HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes more than 10,000 primary care and specialist physicians delivering services to over 200,000 members enrolled in Commercial, Medicare and Medicaid products. Our Management Services Organization employs over 200 skilled staff professionals dedicated to ensuring practices deliver the highest quality of care to their patients while efficiently utilizing healthcare resources.

HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care.

Interested in joining our successful Garden City Team? We are currently seeking a Clinical Pharmacist. 

Position Summary:
The Clinical Pharmacist at a healthcare managed services organization plays a crucial role in ensuring optimal medication management and improving patient outcomes. This position involves reviewing prior authorization requests, evaluating pharmacy utilization, performing medication reconciliation, assisting members with medication adherence, and managing medications for chronic conditions. The Clinical Pharmacist will also assess medications for high-risk members enrolled in case management and for members with recurrent hospital admissions. This role will also assess the appropriateness of sites of service for medication administration, serve as a clinical pharmacy resource for other departments, and contribute to achieving high performance on quality pharmacy measures. Additionally, the Clinical Pharmacist will explore opportunities for improved pharmacy utilization, promote the use of biosimilars when appropriate, review specialty medications, and identify cost containment strategies. Finally, this role will educate and train pharmacy technicians,[providers, and members regarding medication management.

Essential Position Functions/Responsibilities:

Prior Authorization Review

• Review prior authorization requests for medications to ensure appropriateness, safety, and cost-effectiveness
• Assess clinical information and evidence-based guidelines to make informed decisions regarding medication approvals

Pharmacy Utilization Review

• Evaluate pharmacy utilization patterns to ensure medical necessity and optimize medication therapy
• Identify opportunities for cost savings and recommend appropriate interventions, such as formulary changes and generic medication conversions

Medication Reconciliation

• Perform medication reconciliation for members to prevent medication errors and ensure continuity of care, including after hospital discharge and as needed for care management
• Collaborate with healthcare providers and patients to update medication regimens and resolve discrepancies

Medication Adherence Support

• Assist members in improving medication adherence through patient education, counseling, and developing personalized adherence plans
• Collaborate with care management teams to address barriers to adherence and promote medication self-management

Chronic Disease Medication Management

• Provide comprehensive medication management services to members with chronic conditions such as CHF and uncontrolled diabetes
• Collaborate with providers to optimize medication therapy, monitor treatment response, and adjust medications as needed

Clinical Resource and Collaboration

• Remains current with and monitors all State, Health Plan, NCQA and other regulatory bodies to ensure compliance for Clinical Services Department
• Serve as a clinical pharmacy resource for other departments, including Utilization Management and Care Management
• Attend rounds and interdisciplinary meetings to provide expert pharmacy input on inpatients and special needs plan members

Quality Measures and Performance Improvement

• Contribute to achieving excellent performance on quality pharmacy measures, such as medication adherence and statin use in diabetes or cardiovascular disease
• Identify areas for improvement and collaborate with the healthcare team to implement strategies to enhance medication-related outcomes

Specialty Medication Review

• Review specialty medications, including those for transplant and oncology, for appropriateness, adherence, and cost-effectiveness
• Collaborate with providers, specialty pharmacies, and members to ensure optimal        therapy outcomes

Cost Containment and Formulary Compliance

• Identify opportunities for cost containment through formulary non-compliance interventions and brand-to-generic medication conversions
• Monitor formulary compliance and work with the pharmacy team to implement cost-effective medication strategies

Provider and Member Education

• Educate healthcare providers and members on medication management, adherence strategies, and potential drug interactions
• Develop educational materials and participate in training sessions to enhance medication-related knowledge for pharmacy staff, providers, and members

Qualification Requirements:
Skills, Knowledge, Abilities

• Clinical pharmacy experience in a healthcare or managed services organization setting is
• preferred
• Strong knowledge of pharmacy practice guidelines, formulary management, and medication therapy management
• Experience with medication reconciliation, medication adherence programs, and chronic disease management
• Familiarity with specialty medications, including their utilization management and adherence challenges
• Understanding of quality measures related to medication management and pharmacy utilization
• Excellent communication skills to effectively interact with healthcare providers, patients, and interdisciplinary teams
• Strong analytical and problem-solving abilities to interpret and evaluate complex medication-related data
• Ability to work independently, prioritize tasks, and manage multiple responsibilities
• Continuous learning mindset to stay updated with emerging pharmacy practices, guidelines, and regulations

Training/Education:
 

• Doctor of Pharmacy (PharmD) degree from an accredited institution is required
• Current pharmacist licensure in the state of New York
• Completion of a pharmacy residency preferred

Experience:
 

• Minimum of three years experience in managed care environment
• Minimum of three years in medication management
• Experience with pharmacy quality measures
• Experience with utilization management and quality improvement processes
• Experience with claims processes
• Experience with provider/member/staff education

Salary Information:
Annual Base Compensation: $122,000-132,000 
Bonus Incentive: Up to 5%, based on organizational performance

HealthCare Partners, MSO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HealthCare Partners, MSO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

 

Department: Pharmacy
This is a non-management position
This is a full time position

Salary : $122,000 - $132,000