Outpatient Clinical Pharmacy Manager; HSO Pharmacy; Full Time; Remote

Mount Sinai Health System•New York, NY

7d•Remote

About The Position

The Outpatient Pharmacy Clinical Manager is responsible for performing and excelling in leadership, clinical and administrative duties. As a clinician, he/she ensures optimal patient outcomes related to specialty disease state management by preventing or resolving medication related issues and optimizing drug therapy and closely working with the medical clinical leadership to identify, develop and implement continuous improvements in pharmacy clinical services and manage change. Additionally, this individual assists with strategies for growth and present with organization skills, innovation, independence, creativity and flexibility for decision making and problem solving, developing high performing people and teams, leading through change and demonstrating effective decision making.

Requirements

Graduation from an accredited College of Pharmacy with PharmD. (Doctor of Pharmacy degree) required
Active NYS Pharmacist license required
Advanced certifications required (CDE, BCPS, BCGP, CSP, BC-ADM, etc.)
2 or more years of Specialty Pharmacy Practice experience required
6 or more years of hospital clinical experience
NYS Pharmacist licensure

Nice To Haves

Advanced degree preferred (MPH, MBA)
ASHP accredited residency preferred

Responsibilities

Strategically plan for Specialty Pharmacy services growth for all affiliates and members of the Health System and the patients it serves.
Collaborate with all customers, patients and health care professionals that receive service from the Specialty Pharmacy and maintain a high level satisfaction, including excellence in customer service.
Identify service gaps and implement mitigation strategies to improve service.
Work with staff routinely to improve performance, guiding and coaching in solving problems which arise day to day.
Create processes that improve communications, builds teamwork and optimizes job functions to maximize efficiency.
Develop and maintain a positive and healthy culture within all areas of oversight.
Maintain effective communication with patients and working relationships with clients at all levels of the organization as well as business contacts.
Ensure Specialty Pharmacy meets or exceeds accreditation standards and all state and federal laws and regulations pertaining to the pharmacy are complied.
Provide direction and leadership to pharmacists, pharmacy technicians, medication access specialists and healthcare professions.
Assist in the development and revision of policies, procedures and quality improvement projects.
Attend and participate in department staff development conferences.
Train pharmacy technicians, navigators and pharmacists.
Maintain relationship with drug manufacturer vendors and identify opportunities to negotiate for medication access for limited distribution agents.
Negotiate with employers, payers and prescription benefit managers for inclusion of Mount Sinai Specialty Pharmacy in preferred payer networks.
Assume the responsibility and accountability for managing patients’ medication therapy independently or in collaboration with other healthcare team members.
Apply evidence based guidelines, evolving sciences and relevant legal, ethical, social, cultural, economic and professional principles to achieve optimal patient outcomes.
Provide drug and clinical information to the healthcare professionals in response to specific questions relating to the care of patients.
Attend rounds in the clinic areas with the healthcare teams.
Act a resource of communication between outpatient pharmacies and clinical staff.
Participate in medication related research, projects, clinical studies and publishing.
Provide in-service education to physicians, nurses, nurse practitioners, physician assistants, social workers and other healthcare professional.
Report adverse drug reactions to manufacturers.
Participate in Research Board Committee meetings.
Develop appeal letters for off label medication prescribing by submitting appropriate literature to support its utilization and ensuring approvals.
Conduct peer to peers with insurance providers as a process of approvals.
Educate and counsel patients and caregivers on disease state, medication indication, appropriate administration, treatment expectations and strategies for minimizing and managing potential side effects.
Evaluate patient response to medication therapy through direct patient care and monthly clinical outreach calls to ensure, promote and monitor patient compliance to the prescribed medication regimen and perform clinical assessment of pertinent subjective and objective findings.
Investigate and address identified and expected barrier to adherence and implement appropriate adherence promotion strategies.
Manage patient discontinuation of treatment.
Conduct benefits investigation and validation of insurance coverage for requested specialty medications
Determine payer coverage and whether medical or pharmacy claims are required for medications.
Initiate and conduct prior authorization processes.
Manage insurance denials and rejections.
Assist clinic staff with resolving third party barriers.
Act as patients financial advocate; leverage charitable foundations, state programs, patient assistance programs and/or manufacturer programs to ensure maximal patient access.
Facilitate completion of required paperwork for financial assistance on behalf of the patient.
Maintain effective communication with all specialty pharmacies and or third parties to coordinate deliveries and receive timely updates on processing prescriptions.
Resolve situations in which the integrity of medication shipment has been compromised or the shipment was not received from specialty pharmacies.
Assist with management of medication and medication-related problems in clinics.
Other duties as assigned.