Position Summary: We have an exciting opportunity to join our team as a Pharmacy Utilization Management *Boynton Beach,FL*.
In this role, the successful candidate Pharmacy Utilization Management Coordinator contributes to improved health outcomes for patients by collaborating with Faculty Group Practice physicians, voluntary physicians and attributed patients to advise and educate on issues regarding medication. In collaboration with and under the direction of the Pharmacy Utilization Management Manager, this position will drive strategies to improve health outcomes, enhance quality of care and manage costs. This position will work with providers, patients and cross-functional teams across the enterprise to develop effective programs to achieve medication quality targets for shared savings and at risk contracts through NYUPN Clinically Integrated Network and NYU Langone IPA.
Identify and develop methods to optimize patient outcomes related to medication quality measures
Review charts, analyze claims and work with physicians and health plans to review medications for appropriateness, duplications, adherence and compliance, while consulting with patients as necessary
Develop strategies and targeted interventions to manage high cost drug utilization and improve prescribing practices
Partner with prescribers to improve utilization by providing recommendations and education
Collaborate with registered nurse Clinical Care Coordinators to refer patients for health coaching, receive referrals and perform medication coaching/reconciliation
Visits practices on regular basis to discuss data and trends
Assist physicians with individual clinical decision making as requested
Develop clinical interventions, educational programs, tools, policies and clinical guidelines to support disease management and improve medication appropriateness
Identify resources and community partners to support disease management initiatives and patient adherence
Provide pharmacy support to internal/external healthcare professionals as subject matter expert
Identify and discuss medication utilization trends with prescribers, and propose interventions to improve performance
Conduct comprehensive medication reviews/medication reconciliation for patients referred by clinical team or identified by trigger reports
Report outcomes, and trend analyses to appropriate clinical committees for NYUPN and NYU Langone IPA
Develop clinical interventions, track activity, performance improvement and identify new opportunities relating to medication adherence and utilization
Demonstrates knowledge of the organization’s Service Standards and incorporate them into the performance of duties
Coach, mentor and precept pharmacy students and residents
Sees professional development opportunities and participates in projects/activities to maintain professional competence (seminars, journals, 15 hours of continuing education credit per year required by NYS)
Ensure compliance with all regulations
Perform other duties as assigned
Minimum Qualifications: To qualify you must have a NYS and FL Pharmacy License and Registration. Advanced degree in pharmacy related field e.g. Pharm.D., MS, MBA, MPH Three years of relevant experience in Managed Care/ACO/PBM/Medicaid/Government Programs. Strong written and presentation skills. Strong computer knowledge and data analytics (Excel, PowerPoint, Access, Word). Project and resource management. Creative thinking and problem solving. Knowledge of clinical best practices for optimizing medication use.
Required Licenses: USA-Other States Pharm License, Pharmacist License-NYS
Preferred Qualifications: Pharmacy residency, Bilingual in Spanish
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you’ll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU Langone Health’s EEO policies, please click here. Please click here to view the Federal “EEO is the law” poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
NYU Langone —a world-class, patient-centered, integrated, academic medical center—is one of the nation’s premier destinations for excellence in patient care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of Tisch Hospital, our acute care facility; the NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children’s health services; Rusk Rehabilitation, the #1 rehab program in New York since U.S. News & World Report began its hospital rankings in 1989; and a growing ambulatory care network with locations throughout Manhattan, the outer boroughs, and the tri-state area, bringing services directly to where its patients live and work. An integral part of NYU Langone, NYU Grossman School of Medicine has trained thousands of physicians and scientists who have helped to shape the course of medical history and enrich the lives of countless pe...ople since 1841.With more than 75 divisions of specialty care including comprehensive inpatient and outpatient programs for every stage of life, a multifaceted Research and Academic Center and the NYU Long Island School of Medicine focused on primary care. NYU Langone Hospital—Long Island joined NYU Langone Health as of August 2019. NYU Langone's tri-fold mission to serve, teach, and discover is achieved 365 days a year.