Clinical Pharmacist — Quality & Member Outreach

Healthfirst; Pennsylvania; On-site; USD 89,000 - 149,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401k contributions

Incentive and recognition programs

Job summary

Healthfirst is seeking a Clinical Pharmacist to support quality measures for Essential Plan and Medicare populations. The role includes provider and member outreach to address gaps in care, support medication adherence initiatives, and stay current with literature and CMS/NYSDOH guidelines.

The pharmacist will precept residents and students, review monthly reports, and collaborate with Marketing, IT, and Enterprise Analytics to enhance digital outreach while maintaining compliance with

Qualifications

• Requires a Doctor of Pharmacy degree or equivalent and active pharmacist license.
• Strong written and verbal communication; professional clinical dialogue.
• Knowledge of specialty pharmaceuticals and billing practices in medical and pharmacy benefits.

Responsibilities

• Support initiatives to resolve gaps in care through provider and member outreach.
• Ensure recommendations align with latest guidelines and evidence.
• Provide clinical pharmacy support to pharmacy technicians during member outreach for adherence.
• Collaborate with Marketing, IT, and analytics for digital member outreach channels.
• Identify and resolve same-day member grievances per policies.
• Oversee compliance with state and federal agencies; precept residents and students.
• Ensure clinical criteria comply with CMS and NYSDOH requirements.
• Research drug information to maintain disease state knowledge.
• Review monthly reports and provide actionable feedback on trends and efficiency.

Skills

Clinical communication

Pharmacy knowledge

Bilingual ability

Education

Pharmacy degree from an accredited school

Licensed pharmacist in good standing

Job description

Healthfirst is seeking a Clinical Pharmacist to support quality measures for Essential Plan and Medicare populations. The role includes provider and member outreach to address gaps in care, support medication adherence initiatives, and stay current with literature and CMS/NYSDOH guidelines.

The pharmacist will precept residents and students, review monthly reports, and collaborate with Marketing, IT, and Enterprise Analytics to enhance digital outreach while maintaining compliance with