Northwell Health

Clinical Pharmacy Specialist, Pharmacy Benefits Manager (VIVO Health)

Northwell Health$100K — $130K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Doctor of Pharmacy (PharmD) required
  • PGY1 or PGY2 residency preferred
  • 5+ years of clinical pharmacy experience, primarily in managed care settings
  • Experience in formulary management and P&T committee support
  • Background in utilization management criteria development

Responsibilities

  • Develop and monitor medication utilization policies with medical staff and P&T Committee
  • Supervise pharmacists on utilization surveillance and provide education
  • Ensure safe and effective medication use for clinical services
  • Coordinate and implement training and competency programs for staff
  • Facilitate educational outreach for healthcare staff related to medication use
  • Oversee student preceptors and evaluate pharmacy student performance
  • Contribute to formulary development and review activities
  • Initiate and coordinate medication utilization evaluations (MUEs)

Benefits

  • Comprehensive health care benefits
  • Professional development and educational programs
  • Support for specialized certifications
  • Collaborative work environment with medical staff
  • Opportunities to mentor pharmacy students
Full Job Description
The Clinical Pharmacy Specialist is responsible for the development, implementation, and maintenance of drug formularies, clinical utilization management (UM) criteria, and evidence-based drug therapy guidelines, and overseeing pharmacy benefit claims adjudication to match formulary intent. This role involves critical evaluation of clinical literature, pharmacoeconomic data, and regulatory requirements to support P&T Committee decisions and ensure cost-effective, high-quality pharmaceutical care for plan members. Job Responsibility • Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff, Pharmacy, and Therapeutics Committee; monitors medication utilization effectively and intervenes when necessary to ensure compliance. • Monitors pharmacists activities regarding utilization surveillance and provides instruction/education as necessary; maintains necessary and appropriate records regarding the effectiveness of these drug therapy regimens and provides information as required. • Ensures the safe and effective use of medication; guides staff in the provision of clinical services. • Provides necessary, requested information to management for consideration in the staff's performance appraisals; collaboratively, coordinates/implements educational training and competency programs for the staff and pharmacy students. • Provides educational programs for health care staff regarding medication use; provides training as measured by the success of the staff to accomplish identified goals and improve patient care; incorporates professional concerns into the program. • Coordinates activities with the assigned student preceptor and monitors the student's activities and evaluates performance; initiates and implements programs. • Coordinates and participates in the development of the hospital's Formulary and related activities; contributes to the Formulary review process. • Initiates/coordinates MUEs for P&T presentation; discusses findings. • Performs all duties of a licensed registered Pharmacist as required by the leadership and as identified by the ability of the department to effectively provide comprehensive service; maintains compliance with established procedures, policies, and laws in performing the duties of a licensed, registered staff pharmacist. • Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Preferred Skills • Doctor of Pharmacy (PharmD) degree from an accredited College of Pharmacy is essential. • PGY1 or PGY2 Preferred • 5+ years of clinical pharmacy experience post-licensure, with a significant portion (4+ years) directly in a managed care organization, Pharmacy benefit manager, or health plans • Experience in formulary management, P&T committee support, and/or utilization management (PA, ST, QL) criteria development • Experience with benefit design, claims data analysis, and drug information interpretation. Job Qualification • Bachelor of Pharmacy with 1 year internship required, or equivalent combination of education and related experience. • Current License to practice as a Pharmacist in New York State required, plus specialized certifications as needed. • 1-3 years of technical experience, required. *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

About Northwell Health

Northwell Health is a non-profit healthcare organization that provides clinical care, research, and medical education in New York. It is the largest healthcare provider and private employer in the state of New York, with over 72000 employees. Northwell Health has 23 hospitals and more than 700 outpatient facilities, as well as a medical school and a research institute. The organization was founded in 1997 as North Shore-Long Island Jewish Health System and changed its name to Northwell Health in 2015.
Learn more about Northwell Health
Size
72,000 employees
Industry
Founded
1997

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