This is a community-based field opportunity with travel within New York City.
Must reside in NY and be willing to travel 4 days per week within the ACPNY locations (Brooklyn, Manhattan, Queens respectively)
Summary of Position
In support of the EmblemHealth Pharmacy Quality program focused on initiatives to meet corporate STAR goals. As part of the Comprehensive Medication Management Program, conduct interviews, develop, facilitate and communicate a plan of care to remove barriers for members who have been identified as having difficulty with medication adherence. Continuously evaluate plan of care and revise as needed. As part of the Medication Therapy Management Program, conduct and document according to CMS standards annual comprehensive medication reviews.
Principal Accountabilities
As part of the Comprehensive Medication Management Program:
Conduct patient medication history reviews face to face and telephonically.
Identify barriers to care and work collaboratively with the patient to resolve barriers.
Recommend changes in drug therapy and lifestyle based on information obtained through patient interviews, interactions, objective monitoring parameters, review of drug profiles and the patient medical record.
Identify, resolve, and prevent potential and actual medication-related problems including: untreated indications, improper drug selection, subtherapeutic dosage, overdose, failure to receive medication, adverse drug reactions, drug interactions, and medication without indication.
Provide patient monitoring for evaluating and optimizing patient outcomes, drug utilization and patient compliance, detecting and/or minimizing ADR's, eliminating unnecessary drug use and duplication.
Provide patient education related to the individual's disease state, including predictable actions, side effects, reasons for proper compliance, and any special instruction.
Document interactions and care plans within the applicable software.
As part of the Medication Therapy Management Program:
Deliver and accurately document in a timely manner MTM services to assess appropriateness of all medications, optimize medication therapy, improve clinical outcomes and serve as a drug information resource to patients and interdisciplinary teams.
Coordinate medication reconciliation across the continuum of care by providing comprehensive reviews, addressing adherence concerns, assisting with patient education and monitoring clinical outcomes to help prevent unnecessary readmissions, lapses in care and adverse drug reactions.
Assist with managing medication costs through cost-effective interventions which may include, but are not limited to formulary and therapeutic interchanges, and assessing unnecessary and/or duplicate medication therapies.
Efficiently assess prescribed medication therapy for unnecessary medications, need for additional medications, ineffective medications, inappropriate doses, adverse drug reactions, and adherence concerns.
Determine appropriate interventions to resolve medication therapy problems, achieve goals of therapy and prevent new medication therapy problems.
Collaborate with prescribers, interdisciplinary care teams, patients and/or caregivers to identify and develop patient-specific disease state therapy goals.
Communicate professionally and discuss/document clinical recommendations/interventions to prescribers and interdisciplinary care teams.
Ensure maintenance and compliance with clinical standards of the CMMP and MTM services provided, and remain up-to-date with clinical knowledge.
Maintain comprehensive knowledge of policies and procedures, and perform in accordance with applicable regulatory and accreditation requirements or standards as they relate to assigned responsibilities and functions.
Aid in the evaluation and maintenance of formulary set-up based on clinical requirements, compliance with regulatory bodies, and P&T rules.
Other projects/ duties as assigned.
Qualifications
Bachelors' Degree
PharmD from an accredited college of pharmacy
Current, unrestricted Pharmacist License in accordance with a respective state licensing board of residency
MTM training program completion by APhA or PowerPak C.E. preferred
PGY-1 residency program in community pharmacy/ambulatory care/geriatric pharmacy/managed care pharmacy preferred
Clinical Pharmacy Board Certified via BPS or NBMTM preferred
Fluent in an additional one or more languages preferred
10+ years of relevant, professional work experience
3 - 5 years specific, position-related experience
Experience with administering CMS Comprehensive Medication Reviews
Managed care experience
Strong communication skills, including motivational interviewing
Strong clinical therapeutic skills; knowledge of appropriate medication dosing in geriatric and adult populations
Excellent critical thinking and problem-solving skills
Computer/technology competent
Industry level understanding of STAR measures and methods for improving service delivery to maximize ratings
Ability to work independently in a collaborative environment, be self-directed and possess excellent organizational skills
Ability to work effectively with patients, their families, professionals, and other personnel from a wide range of cultural, social and economic backgrounds
Ability to communicate professionally with all necessary parties associated with the patient's care plan
Additional Information
Requisition ID: 2603Q
Hiring Range: $92,880-$178,200
Numbers & Facts
Location
New York, NY
Salary
$92,880–$178,200 Per Year
Skills
Adverse Eventsunmatched
Ambulatory Careunmatched
Clinical Competencyunmatched
Clinical Monitoringunmatched
Clinical Outcomesunmatched
Clinical Practices/Protocolsunmatched
Clinical Study Publicationsunmatched
Communication Skillsunmatched
Community Programsunmatched
Content Management Systems (CMS)unmatched
Cost Controlunmatched
Diseaseunmatched
Drug Interactionsunmatched
Drug Therapyunmatched
Formularyunmatched
Geriatricsunmatched
Health Planunmatched
Interviewing Skillsunmatched
Licensingunmatched
Maintain Complianceunmatched
Managed Careunmatched
Medical Recordsunmatched
Medication Administrationunmatched
Medicationsunmatched
Organizational Skillsunmatched
Patient Assessmentunmatched
Patient Careunmatched
Patient Educationunmatched
Pharmacyunmatched
Prescription Drugsunmatched
Problem Solving Skillsunmatched
Reconciliationunmatched
Regulationsunmatched
Regulatory Complianceunmatched
Service Deliveryunmatched
Team Playerunmatched
Time Managementunmatched
Training Programunmatched
Treatment Planunmatched
Willing to Travelunmatched
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