Clinical Pharmacy Specialist, Pharmacy Benefits Manager (VIVO Health) Job at Northwell Health, New Hyde Park, NY

K2k3ZGpWVEJRWXZHWWFKVkQrd1h6WW5sQWc9PQ==
  • Northwell Health
  • New Hyde Park, NY

Job Description

Job Description

\n

Job Description

\n

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.

\n

Job Responsibility

\n
    \n
  • 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.
  • \n
  • 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.
  • \n
  • Ensures the safe and effective use of medication; guides staff in the provision of clinical services.
  • \n
  • 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.
  • \n
  • 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.
  • \n
  • Coordinates activities with the assigned student preceptor and monitors the student’s activities and evaluates performance; initiates and implements programs.
  • \n
  • Coordinates and participates in the development of the hospital’s Formulary and related activities; contributes to the Formulary review process.
  • \n
  • Initiates/coordinates MUEs for P&T presentation; discusses findings.
  • \n
  • 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.
  • \n
  • 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.
  • \n
\n

Preferred Skills

\n
    \n
  • Doctor of Pharmacy (PharmD) degree from an accredited College of Pharmacy is essential.
  • \n
  • PGY1 or PGY2 Preferred
  • \n
  • 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
  • \n
  • Experience in formulary management, P&T committee support, and/or utilization management (PA, ST, QL) criteria development 
  • \n
  • Experience with benefit design, claims data analysis, and drug information interpretation.
  • \n
\n

Job Qualification

\n
    \n
  • Bachelor of Pharmacy with 1 year internship required, or equivalent combination of education and related experience.
  • \n
  • Current License to practice as a Pharmacist in New York State required, plus specialized certifications as needed.
  • \n
  • 1-3 years of technical experience, required.
  • \n
\n


*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).

Job Tags

Hourly pay,

Similar Jobs

Hall Contracting LLC

Project Manager Job at Hall Contracting LLC

 ...Job Description Job Description We are seeking a Project Manager to join our team! You will oversee project planning, scheduling, budgeting, and implementation of multiple concurrent projects managing work of 3-5 install crews and various subcontractors. Responsibilities... 

Delta Fuel

Accounting Specialist Job at Delta Fuel

 ...customer sales order processing. AR customer invoice, statement, and receipt processing. Bill of lading and delivery ticket review. Customer pricing analysis and tax review. Assist in period closing procedures and account reconciliation Accounting, Specialist, Account... 

Everything But The House

Product Photographer Job at Everything But The House

 ...platform is authenticated or validated, presented clearly and accurately, and is handled with the utmost care. Were seeking a Product Photographer who will be responsible for capturing professional and compelling images as true representations of auction items that... 

Medasource

Local Contract Level II - RDN - Registered Dietitian Nutritionist Job at Medasource

 ...RDN - Registered Dietitian Nutritionist ~ Discipline: Allied Health Professional ~ Start Date: ASAP ~ Duration: 52 weeks ~40...  ...Time Schedule: 40 hours per week Job Category: Clinical Remote Eligibility: Part Remote/Hybrid Status: Full-Time\n\nSchedule... 

Brigit

Senior CRM Marketing Manager Job at Brigit

 ...innovative and exciting work, but dont just take our word for it, our work is being recognized by others: The Role: As the Senior CRM Marketing Manager, you will contribute to day-to-day operations for major Brigit CRM channels (Email, SMS, in-app and push) including...