Clinical Pharmacist

Healthfirst; New York (NY); Hybrid; USD 103,000 - 149,000; Full time

Job summary

Healthfirst seeks a Clinical Pharmacist to support quality measures for Essential Plan and Medicare populations. The role involves provider and member outreach to address gaps in care, support medication adherence initiatives, and help develop strategies to improve quality while maintaining compliance with federal and state agencies.

The position requires staying current with literature and trends in medicine, precepting Pharmacy Residents and Students, and collaborating with teams across

Qualifications

• Pharmacy degree from an accredited school of pharmacy.
• Registered Pharmacist with a state license in good standing.
• Strong written and verbal clinical communication skills.

Responsibilities

• Support initiatives to resolve gaps in care through provider and member outreach.
• Provide clinical pharmacy support to pharmacy technicians during member outreach on adherence.
• Collaborate with Marketing, IT, and Analytics for strategic digital communications.
• Oversee regulatory compliance with State and Federal agencies.

Skills

Clinical communication

Team collaboration

Literature review

Public outreach

Education

Pharmacy degree from accredited school

Tools

MS Office / Excel

CMS/NYSDOH knowledge

Job description

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

Equal Opportunity Employment

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. 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, please contact us by sending an email to [e-mail] 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 HF Management Services, LLC will be reviewed at the e‑mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.

Know Your Rights

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): $103,400 - $149,430 All Other Locations (within approved locations): $88,700 - $131,920

*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.

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. Healthfirst is New York’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable healthcare. As part of the community for nearly 30 years, Healthfirst’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well-being. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then Healthfirst is for you.