Position Summary: We have an exciting opportunity to join our team as a Pharmacy Utilization Management Coordinator.
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
Maintains a close relationship to the Pharmacy & Therapeutics committee, reporting outcomes, data and trend analyses to both the Clinically Integrated Network and the committee
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 organizations 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 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: Pharmacist License-NYS
Preferred Qualifications: Pharmacy residency
Qualified candidates must be able to effectively communicate with all levels of the organization.
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.
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Internal Number: 61413098
About NYU Langone Health
NYU Langone Health, a world-class patient-centered integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the medical center – plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.nyulangone.org.