Clinical Pharmacist

Amida Care-posted about 1 month ago
Full-time • Mid Level
New York, NY
101-250 employees
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Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member. We are a community of individuals from diverse people who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. Visit http://www.amidacareny.org for more information about the Amida Care culture. We are actively seeking a highly motivated, innovative and experienced contributor to join our team as the Clinical Pharmacist. Compensation will be commensurate with experience. Position Summary: The role serves as a key contributor to all clinical pharmacy initiatives and related activities. This person monitors clinical trends and utilization patterns, providing strategic solutions to achieve optimal outcomes for members. They design and implement customized programs to enhance the quality of pharmaceutical care. The position also supports utilization management activities and contributes to improving quality scores by ensuring members receive safe, effective, and cost-efficient medication therapy.

  • Responsible for Pharmacy HEDIS/QARR performance improvement process for Pharmacy related measures.
  • Responsible for making real time interventions with the prescribers, providers, members and case management staff to facilitate optimal drug therapy.
  • Critically evaluates a member s medication profile to ensure that each medication is indicated, effective, safe, and that the patient is adherent to therapy.
  • Develops and implements drug use reviews (DURs) as required to demonstrate impact of pharmaceutical services and outcomes.
  • Interacts with members, caregivers/family, and providers(s), to obtain essential clinical information required to evaluate patient history and current state of health.
  • Maintains required documentation for all activities and medication recommendations.
  • Responsible for the implementation and maintenance of the utilization management of Physician administered Drugs (PAD) which will allow the plan to cover high-cost drugs solely for medical necessity.
  • Establishes, maintains and enhances supportive relationships with Amida Care Providers (prescribers and pharmacists) and conducts academic detailing to enhance drug information and utilization patterns.
  • Development and analysis of pharmacy reports to determine opportunities for clinical and/or operational intervention, mitigation of fraud, waste and abuse and improvement of overall quality measures.
  • Develops technical solutions to complex problems which require the regular use of ingenuity and creativity.
  • Works collaboratively with internal stakeholders: Chief Medical Officer, medical directors, pharmacists, pharmacy technicians, nurse case managers, social workers, behavioral health specialists, case management, etc.
  • Presents complex medical management cases to Clinical Committees as required to maximize outcomes and reduce/avoid costs.
  • Works independently, with guidance in only the most complex situations.
  • Demonstrates a high level of energy, enthusiasm and self-motivation.
  • Performs other duties as assigned.
  • A Doctor of Pharmacy Degree from an accredited college of pharmacy; is required.
  • Maintains an active New York State (NYS) Pharmacy license.
  • Knowledge of HIV, psychopharmacology and/or pain management.
  • One (1) to two (2) years of experience at a Health Plan organization, preferred.
  • Two (2) to three (3) years of successful experience working with targeted population.
  • Strong written and verbal communication skills in English.
  • Strong knowledge of Microsoft Office (Word, Excel, & PowerPoint).
  • Demonstrates understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
  • Demonstrates appropriate behaviors in accordance with the organization s vision, mission, and values.
  • Board Certification in Pharmacy Specialty (e.g. AAHIVP, BCPS) preferred.
  • Accredited Pharmacy Residency preferred.
  • Experience with QARR/HEDIS, preferred.
  • Working knowledge of Retail Pharmacy and/or Specialty Pharmacy; familiarity with a variety of pharmacy concepts, dispensing practices and procedures.
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