Clinical Pharmacist
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Clinical Pharmacist improving medication adherence and quality measures for Healthfirst’s Essential Plan and Medicare members. Supporting outreach, regulatory compliance, and clinical pharmacy initiatives.
Responsibilities:
- Support initiatives to resolve gaps in care through direct provider and member outreach, collaboration with provider engagement, and leveraging pharmacy network capabilities
- Ensure recommendations are consistent with the latest guidelines or supported by clinical compendia
- Provide clinical pharmacy support to pharmacy technicians conducting member outreaches regarding medication adherence
- Resolve barriers to adherence and use motivational interviewing to improve member health
- Collaborate with Marketing, IT, and Enterprise Analytics on strategic digital communication channels for member outreach
- Identify and resolve same-day member grievances according to policies and procedures
- Oversee and maintain compliance with State and Federal agencies
- Precept Pharmacy Residents and Students
- Ensure clinical criteria comply with CMS and NYSDOH requirements
- Research drug information to maintain drug knowledge and disease-state understanding
- Review monthly reports and provide feedback on trends, efficiency, and innovation
- Assist in regulatory and compliance audits for all plans
- Perform additional duties as assigned or required
Requirements:
- Pharmacy degree from an accredited school of pharmacy
- Registered Pharmacist, with a state license in good standing
- Work experience requiring written and verbal clinical communication that is clear, concise, grammatically correct, and professional
- Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits
- Bilingual in English and one or more language(s): Spanish, Mandarin, Cantonese may be required based on business needs
- Ability to work well in a team environment and be a team player
- Demonstrated critical thinking and problem-solving skills
- Passion for learning, promoting the profession of pharmacy, and interest in growing skills in a dynamic environment with various opportunities
- Knowledge of regulations of the Centers for Medicare and Medicaid Services including but not limited to National and Local Coverage Determinations
- Ability to lead large and small working meetings
- PC Skills with Microsoft Outlook, Word, PowerPoint (creating presentations and slides), and Excel (Pivot tables)
- Licensed pharmacist in good standing
Benefits:
- Medical, dental and vision coverage
- Incentive and recognition programs
- Life insurance
- 401k contributions
- Competitive compensation and benefits package
Similar Jobs
Pharmacy Technician, CPhT
Remote CPhT handling medication renewals for HarmonyCares’ in-home primary care patients. Supporting centralized patient advocacy, EMR documentation, and prescription workflows.
Clinical Pharmacist – Cost Containment
Clinical Pharmacist optimizing medication utilization and cost-containment programs for TrueScripts, a transparent prescription benefit manager. Analyzing clinical and financial outcomes while supporting PBM operations.
Clinical Review Pharmacist
Clinical Review Pharmacist reviewing prior authorizations and appeals for SmithRx’s technology-driven pharmacy benefit management platform. Supporting members, providers, pharmacies, and clinical programs remotely.
Pharmacy Assistant
Remote Pharmacy Assistant processing prescriptions, inventory, billing, and medication shipments. Supporting Sentrex Health Solutions’ Canadian specialty pharmacy and patient-support programs.
Pharmacist
Remote Canadian Pharmacist dispensing specialty medications and supporting clinics for Sentrex Health Solutions. Managing prescription verification, patient counselling, billing, inventory, and compounding.
Associate Director – Pharmacy Hub Operations
Associate Director launching and leading patient and provider service operations for CenterWell Pharmacy. Managing omnichannel support, workforce performance, quality, compliance, and complex resolutions.
Healthcare Consulting Associate – Pharmacy
Healthcare consulting associate leading pharmacy project workstreams for Huron. Improving hospital operations, clinical outcomes, cost structures, and sustainable performance through data-driven recommendations.
Pharmacist 2, Inpatient – Centralized Order Verification for the Enterprise
Inpatient Pharmacist verifying enterprise medication orders for the University of Rochester medical center. Supervising dispensing, clinical pharmacy care, technicians, and medication safety processes.
Clinical Pharmacist
Clinical Pharmacist optimizing medication therapy and chronic disease outcomes through WellDyne’s clinical programs. Conducting patient consultations, drug reviews, and provider engagement remotely.
Pharmacy Intern
Unpaid part-time Pharmacy Intern supporting Humana’s healthcare and insurance services remotely in South Carolina. Completing pharmacy assignments while pursuing formal education.
Senior Integrated Clinic Pharmacist
Clinical pharmacist managing medications, education, and quality initiatives for Conviva’s senior primary care patients. Supporting high-risk chronic-care outcomes across remote clinic operations.
Clinical Pharmacist, Arizona/New Mexico
Clinical Pharmacist optimizing Medicare drug therapy quality and cost-effectiveness for HCSC. Supporting pharmacy programs, provider groups, and clinical teams remotely in Arizona or New Mexico.
Pharmacy Outreach Supervisor
Remote Pharmacy Outreach Supervisor leading patient outreach teams for Shields Health Solutions’ hospital-based pharmacy partners. Managing coaching, compliance, workflows, hospital collaboration, and team performance.
Prior Authorization Pharmacy Technician – Rhode Island Pharmacy License
Patient Support Advocate helping patients access specialty medications through prior authorizations, insurance navigation, and financial assistance. Supporting adherence and pharmacy operations for Shields Health Solutions.
Prior Authorization Pharmacy Technician – New Hampshire Pharmacy License
Patient Support Advocate helping Shields Health Solutions patients access medications through prior authorization, insurance navigation, and financial assistance. Supporting pharmacy operations, adherence, and patient care coordination.
Prior Authorization Pharmacy Technician, Massachusetts Pharmacy License
Patient Support Advocate supporting medication access through prior authorizations, insurance navigation, and financial assistance. Serving patients for Shields Health Solutions, a specialty pharmacy services company.
Prior Authorization Pharmacy Technician, Connecticut License
Patient Support Advocate supporting prior authorizations, insurance navigation, and financial assistance for specialty medications. Helping patients improve medication access and adherence at Shields Health Solutions.
Senior Director, Pharmacy Solutions – Oncology
Senior oncology pharmacy leader advancing drug strategy and practice performance across McKesson’s US Oncology Network. Leading pharmacy directors, enterprise initiatives, and oncology drug economics.
Pharmacist / Pharmacy Technician – Medication Pronunciation Reviewer
U.S.-based pharmacists or pharmacy technicians reviewing spoken medication names for accuracy. Supporting Mercor’s AI systems through structured audio evaluation and feedback.
Clinical Prior Authorization Pharmacist
Pharmacist talent community for future clinical prior authorization opportunities at Navitus, a pharmacy benefit manager reducing medication costs. Connecting experienced pharmacy professionals with potential future roles.