EmblemHealth

Lead Clinical Pharmacy Specialist - Field Based New York City

EmblemHealth • $100K — $130K *
New York, NY 10025In-Person
Healthcare
8 - 10 years of experience
3 weeks ago
Job Overview by Ladders

Qualifications

  • PharmD from an accredited college of pharmacy
  • Current, unrestricted Pharmacist License
  • MTM training program completion preferred
  • 10+ years of relevant work experience
  • 3-5 years position-related experience
  • Strong communication skills, including motivational interviewing
  • Excellent critical thinking and problem-solving skills

Responsibilities

  • Conduct face-to-face and telephonic patient medication history reviews
  • Identify and resolve barriers to patient medication adherence
  • Document care plans within applicable software
  • Deliver and document MTM services in a timely manner
  • Coordinate medication reconciliation across the continuum of care
  • Collaborate with prescribers and interdisciplinary teams on patient goals
  • Ensure compliance with CMMP and MTM clinical standards

Benefits

  • Comprehensive training and development opportunities
  • Supportive work environment with a focus on quality care
  • Opportunity for professional growth within a reputable organization
  • Ability to engage with diverse patient populations
  • Flexible and travel-friendly work schedule within NYC
Full Job Description
This is a community-based field opportunity with travel within New York City.
Must reside in NY and be willing to travel 4 days per week within the ACPNY locations (Brooklyn, Manhattan, Queens respectively)

Summary of Position

In support of the EmblemHealth Pharmacy Quality program focused on initiatives to meet corporate STAR goals. As part of the Comprehensive Medication Management Program, conduct interviews, develop, facilitate and communicate a plan of care to remove barriers for members who have been identified as having difficulty with medication adherence. Continuously evaluate plan of care and revise as needed. As part of the Medication Therapy Management Program, conduct and document according to CMS standards annual comprehensive medication reviews.

Principal Accountabilities

As part of the Comprehensive Medication Management Program:
  • Conduct patient medication history reviews face to face and telephonically.
  • Identify barriers to care and work collaboratively with the patient to resolve barriers.
  • Recommend changes in drug therapy and lifestyle based on information obtained through patient interviews, interactions, objective monitoring parameters, review of drug profiles and the patient medical record.
  • Identify, resolve, and prevent potential and actual medication-related problems including: untreated indications, improper drug selection, subtherapeutic dosage, overdose, failure to receive medication, adverse drug reactions, drug interactions, and medication without indication.
  • Provide patient monitoring for evaluating and optimizing patient outcomes, drug utilization and patient compliance, detecting and/or minimizing ADR's, eliminating unnecessary drug use and duplication.
  • Provide patient education related to the individual's disease state, including predictable actions, side effects, reasons for proper compliance, and any special instruction.
  • Document interactions and care plans within the applicable software.
    As part of the Medication Therapy Management Program:
  • Deliver and accurately document in a timely manner MTM services to assess appropriateness of all medications, optimize medication therapy, improve clinical outcomes and serve as a drug information resource to patients and interdisciplinary teams.
  • Coordinate medication reconciliation across the continuum of care by providing comprehensive reviews, addressing adherence concerns, assisting with patient education and monitoring clinical outcomes to help prevent unnecessary readmissions, lapses in care and adverse drug reactions.
  • Assist with managing medication costs through cost-effective interventions which may include, but are not limited to formulary and therapeutic interchanges, and assessing unnecessary and/or duplicate medication therapies.
  • Efficiently assess prescribed medication therapy for unnecessary medications, need for additional medications, ineffective medications, inappropriate doses, adverse drug reactions, and adherence concerns.
  • Determine appropriate interventions to resolve medication therapy problems, achieve goals of therapy and prevent new medication therapy problems.
  • Collaborate with prescribers, interdisciplinary care teams, patients and/or caregivers to identify and develop patient-specific disease state therapy goals.
  • Communicate professionally and discuss/document clinical recommendations/interventions to prescribers and interdisciplinary care teams.
  • Ensure maintenance and compliance with clinical standards of the CMMP and MTM services provided, and remain up-to-date with clinical knowledge.
  • Maintain comprehensive knowledge of policies and procedures, and perform in accordance with applicable regulatory and accreditation requirements or standards as they relate to assigned responsibilities and functions.
  • Aid in the evaluation and maintenance of formulary set-up based on clinical requirements, compliance with regulatory bodies, and P&T rules.
  • Other projects/ duties as assigned.


Qualifications
  • Bachelors' Degree
  • PharmD from an accredited college of pharmacy
  • Current, unrestricted Pharmacist License in accordance with a respective state licensing board of residency
  • MTM training program completion by APhA or PowerPak C.E. preferred
  • PGY-1 residency program in community pharmacy/ambulatory care/geriatric pharmacy/managed care pharmacy preferred
  • Clinical Pharmacy Board Certified via BPS or NBMTM preferred
  • Fluent in an additional one or more languages preferred
  • 10+ years of relevant, professional work experience
  • 3 - 5 years specific, position-related experience
  • Experience with administering CMS Comprehensive Medication Reviews
  • Managed care experience
  • Strong communication skills, including motivational interviewing
  • Strong clinical therapeutic skills; knowledge of appropriate medication dosing in geriatric and adult populations
  • Excellent critical thinking and problem-solving skills
  • Computer/technology competent
  • Industry level understanding of STAR measures and methods for improving service delivery to maximize ratings
  • Ability to work independently in a collaborative environment, be self-directed and possess excellent organizational skills
  • Ability to work effectively with patients, their families, professionals, and other personnel from a wide range of cultural, social and economic backgrounds
  • Ability to communicate professionally with all necessary parties associated with the patient's care plan

About EmblemHealth

EmblemHealth is a non-profit health insurance company based in New York City. It is one of the largest non-profit health insurers in the United States, serving over 3 million people. EmblemHealth offers a range of health insurance plans, including HMO, PPO, and EPO plans, as well as Medicare and Medicaid plans. The company also offers wellness programs and disease management services. EmblemHealth was formed in 2006 through the merger of Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP). The company has offices in New York City and Albany, New York.
Learn more about EmblemHealth
Size
3,000 employees
Industry
Healthcare
Net Income
-$100 million
Founded
2006
5 Year Trend
-5%
Revenue
$10 billion
NASDAQ
* Ladders Estimates

Similar Jobs

Ad banner background

Get Ready For Your
Next Interview

More Jobs at EmblemHealth

More Healthcare Jobs

Find similar Lead Clinical Pharmacy Specialist - Field Based New York City jobs:

NationwideNew York, NY