Jobs
>
Rochester

    Quality Improvement Clinical Pharmacist I - Rochester, United States - Excellus Health Plan Inc.

    Excellus Health Plan Inc.
    Excellus Health Plan Inc. Rochester, United States

    2 weeks ago

    Default job background
    Description

    Job Description:

    Summary:
    The Quality Improvement Clinical Pharmacist position participates in a wide range of provider and patient initiative programs.

    The overall goal of the position is to work collaboratively within the department, division and across the organization to help drive quality improvement in all Lines of Business (LOB).

    Unique programs or initiatives may be specific to a LOB or focus on the entire health plan population.

    The Pharmacist works collaboratively with others as a member and representative of an interdisciplinary quality team that can be LOB specific or targeting the entire health plan population.


    Medicare Focus:


    The primary responsibility for the Medicare LOB will be to support internal staff and oversee external vendors that perform Comprehensive Medication Reviews (CMRs), Targeted Medication Reviews (TMRs), as well as develop programs that support these efforts.

    Additionally, the pharmacist will be part of an interdisciplinary team that is focused on STAR improvement for Part C and Part D measures.


    Medicaid Focus:


    The primary responsibility for the Medicaid LOB will be to work collaboratively with the Health Care Improvement team on QARR measures.

    They will act as the subject matter expert as it relates to drug therapy and quality improvement. Additionally, they will support other departments that focus on the quality of care that our members receive.

    They may participate in cross-functional teams that look at prescribing habits of physicians or overutilization of services by our members.


    Essential Primary Responsibilities/Accountabilities:

    Level I:


    Work with leadership to develop clinical programs that focus on quality measures that are industry standard metrics such as QARR, STARs, HEDIS, PQA and others.

    Develop written documents for members and providers regarding drug therapy strategies such as inappropriate use, over/under utilization, gaps in care, etc.

    Conduct telephonic consultations with our members regarding their drug therapy and disease states
    Provides disease specific educational materials and self-monitoring devices, as appropriate.
    Participates in the core Pharmacy Quality Strategy meeting to help maintain and improve the program
    Works in matrix collaboration with other departments including Health Care Improvement, Communications, Provider Relations, Customer Care and Medical Services
    Oversee and monitor CMS requirements for the Opioid Drug Management Program
    Provides comprehensive support directly to both providers and pharmacies.
    Provides guidance, instruction and mentoring of pharmacy and other health care students involved in experiential rotations in the department.

    Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.

    Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
    Regular and reliable attendance is expected and required.
    Performs other functions as assigned by management.

    Level II (in addition to Level I essential responsibilities/accountabilities):

    Understand Line of Business (LOB) differences and similarities and be able to handle cross functional responsibilities outside of their own primary LOB
    Collaborate with the pharmacy strategy team to drive quality improvement through drug formulary alignment
    Works independently in coordinating and collaborating with members and providers, resulting in improving member and community health
    Engage with our Accountable Cost and Quality Agreements (ACQA) entities to develop unique programs that support our quality improvement projects

    Offers process improvement suggestions and participates in the solutions of more complex issues/activities as it relates to both internal programs and the work that our vendors perform.

    Be the team lead on projects and develop charters that include an AIM statement, appropriate outcome and process measures, tracks progress and are able to present the results to appropriate committees.

    Displays leadership and serves as a positive role model to others in the department.
    Develops new methods of engaging members to become more involved in their drug regimen and overall health.

    Serves as a resource to internal and external customers for specific therapeutic topics where the clinical pharmacist is considered a content expert.

    Trains new staff on MTM software and provides education to them regarding CMS MTM requirements and Star measures.


    Minimum Qualifications:

    NOTE:

    We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others.

    In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.


    All levels:
    Current New York State Pharmacist with doctoral level (Pharm.
    D) degree and a minimum of two years of experience in an organized health care setting.

    In lieu of degree, a Bachelor's degree (BSRPh) and a minimum of two years of experience in an organized health care setting will be considered.

    Excellent verbal and written communication skills with experience communicating with patients (our members) and health care professionals.
    Knowledge and skill to conduct a thorough drug regimen review. Strong clinical knowledge base, kept current through continuing education and professional affiliations.
    Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities.
    Strong computer skills. Proficient knowledge of Microsoft Word and Excel. Ability to learn new systems.
    Basic knowledge of CMS minimum standards for MTM services is desired.

    Level III (in addition to Level I minimum qualifications):

    Minimum of five years of clinical pharmacy experience including participation in patient management initiatives.
    Prior accountability for implementation of a new program or initiative that focused on quality improvement or member/provider engagement
    Additional certification in a specialized area such as Geriatric Pharmacy, Pharmacoeconomics, or Medication Therapy Management is preferred.
    Advanced knowledge of CMS requirements and standards for MTM services.
    Advanced knowledge of the variety of quality measures that have a direct impact on Health Plan performance
    Proficient knowledge of Power Point and past experience presenting to large cross functional groups with a diverse background (business, finance, clinical, etc.)


    Physical Requirements:
    Ability to travel frequently across New York State and neighboring areas is required.
    Some travel required out of area. Must have ability to travel.

    The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.

    Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture.

    We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services.

    With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.

    OUR COMPANY CULTURE:


    Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

    In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

    Equal Opportunity Employer

    Compensation Range(s):

    Level I:

    Grade 210:
    Minimum $85, 44- Maximum $158, 080

    Level II:
    Grade 210A: Minimum $99, 13- Maximum $183, 394
    The salary range indicated in this posting represents the minimum and maximum of the salary range for this position.

    Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity.

    The posted salary range reflects just one component of our total rewards package.

    Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.


    Please note:
    There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

    Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity

    Minimum Salary: 0.00
    Maximum Salary: 0.00

    Salary Unit:
    Yearly
  • Rochester Regional Health

    Clinical Pharmacist

    2 weeks ago

    Rochester Regional Health Rochester, United States

    HOW WE CARE FOR YOU: · At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community. · Paid Time O ...

  • Rochester Regional Health

    Clinical Pharmacist

    1 week ago

    Rochester Regional Health Rochester, United States Full time

    HOW WE CARE FOR YOU: · At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community. · Paid Time O ...

  • Rochester Regional Health

    Clinical Pharmacist

    6 days ago

    Rochester Regional Health Rochester, United States Full time

    HOW WE CARE FOR YOU: · At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community. · Paid Time O ...

  • University of Rochester

    Pharmacist Clinical Specialist

    1 week ago

    University of Rochester Rochester, United States Full time

    GENERAL PURPOSE: · The clinical pharmacy specialist is responsible for the provision of comprehensive clinical pharmacy services related to their area of practice to optimize safe, effective and cost-effective drug therapy. Activities may include participation as a member of an i ...

  • Comprehensive Pharmacy Services

    clinical/specialty pharmacist

    3 weeks ago

    Comprehensive Pharmacy Services Rochester, NY, United States

    Clinical/Specialty Pharmacist · Rochester Regional Hospital · Rochester, NY · CPS Solutions is seeking highly motivated and customer service-oriented pharmacy professionals who want to elevate their career to the next level. We are currently conducting a search for a full time, e ...

  • Mvp Health Plan Inc

    Professional, Clinical Pharmacist

    6 days ago

    Mvp Health Plan Inc Rochester, United States

    Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a di ...

  • The University of Rochester

    Pharmacist 2, Clinical Spec

    3 weeks ago

    The University of Rochester Rochester, United States

    The clinical pharmacy specialist is responsible for the provision of comprehensive clinical pharmacy services related to their area of practice to optimize safe, effective and cost-effective drug therapy. Activities may include participation as a mem Clinical, Pharmacist, Neuro, ...

  • University of Rochester

    Pharmacist 2, Clinical Spec

    1 week ago

    University of Rochester Rochester, United States

    GENERAL PURPOSE: · The clinical pharmacy specialist is responsible for the provision of comprehensive clinical pharmacy services related to their area of practice to optimize safe, effective and cost-effective drug therapy. Activities may include participation as a member of an i ...

  • University of Rochester

    Pharmacist - Clinical Specialist II (Toxicology)

    1 week ago

    University of Rochester Rochester, United States

    GENERAL PURPOSE: · The toxicology clinical pharmacy specialist is responsible for the provision of comprehensive clinical pharmacy services in the area of toxicology and emergency medicine to optimize safe, effective and cost-effective drug therapy. Activities include participati ...

  • University of Rochester

    Pharmacist Inpatient Clinical II ¿ Evenings

    6 days ago

    University of Rochester Rochester, United States

    Responsibilities · Join our team as a Level II Clinical Pharmacist and make a significant impact on patient care at our esteemed academic medical center, recognized as a level 1 trauma center. We are seeking passionate individuals who are dedicated to upholding the highest standa ...

  • University of Rochester

    Pharmacist Clinical Specialist II- Specialty Pharmacy

    1 week ago

    University of Rochester Rochester, United States Full time

    Opening · Full Time 40 hours Range URCD 219 Pharmacy SMH · Responsibilities · GENERAL PURPOSE: · The clinical pharmacy specialist is responsible for the provision of comprehensive clinical pharmacy services related to their area of practice to optimize safe, effective and cost-ef ...

  • Rochester Regional Health

    Clinical Pharmacist

    2 weeks ago

    Rochester Regional Health Batavia, United States

    HOW WE CARE FOR YOU: · At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community. · Paid Time O ...

  • Rochester Regional Health

    Clinical Pharmacist

    2 weeks ago

    Rochester Regional Health Batavia, United States Full time

    HOW WE CARE FOR YOU: · At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community. · Paid Time O ...

  • Rochester Regional Health

    Clinical Pharmacist

    2 weeks ago

    Rochester Regional Health Batavia, United States

    HOW WE CARE FOR YOU: · At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community. · Paid Time O ...

  • Rochester Regional Health

    Ambulatory Care Clinical Pharmacist, High Cost Drugs

    2 weeks ago

    Rochester Regional Health Rochester, United States

    Job Objectives · The Ambulatory Care Clinical Pharmacist, High Cost Drugs is responsible for the promotion of rational, cost-effective prescribing of medication therapy for contracted membership in collaboration with patients and providers. · A successful candidate must be able t ...

  • Soliant

    WI Licensed Clinical Travel Pharmacist 3-Years Experience Required WI

    1 week ago

    Soliant Rochester, United States

    Minimum 1+ years pharmacy experience required. · We are currently seeking a Clinical Pharmacist for a contract travel position at a hospital in Stevens Point, WI. This role presents an excellent opportunity for experienced pharmacists looking to apply their skills in a dynamic he ...

  • Fresenius Medical Care

    Charge Registered Nurse

    1 week ago

    Fresenius Medical Care Rochester, United States Full time

    PURPOSE AND SCOPE: · Works with the Facility Manager, facility staff and physician to coordinate the facility operations and patient procedures to ensure provision of quality patient care on a daily basis in accordance with organization policies, procedures and training. Provides ...

  • University of Rochester

    Pharmacist,Pnd Lic,Out ofState

    3 weeks ago

    University of Rochester Rochester, United States

    GENERAL PURPOSE: · This is a temporary job classification, not to exceed 6 months, limited to pharmacists who have an active and current license in another jurisdiction (e.g. state) and are eligible for and pending licensure and registration in New York State. The out of state ph ...

  • The University of Rochester

    Pharmacist, Clin Info Spec I

    1 week ago

    The University of Rochester Rochester, United States

    Pharmacist - Clinical Informatics Specialist I participates in the design and development of workflows utilizing pharmacy technology to optimize the safety and efficiency of the organizations medication use system. The primary responsibilities of the Pharmacist, Clinical, Operati ...

  • Highland Hospital

    Staff Pharmacist, Emphasis in Medication Management

    3 weeks ago

    Highland Hospital Rochester, United States

    **14925BR** · **Title:** · Staff Pharmacist, Emphasis in Medication Management · **Department/Cost Center:** · 756 - Lobby Pharmacy · **Job Description:** · Responsible for acting as an information resource to patients, physicians, nurses, and other healthcare professionals regar ...