Pharmacy Resident

About the role

MetroPlusHealth is a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States. It provides comprehensive healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens, and Staten Island, including Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. Through a network of over 27,000 primary care providers, specialists, and participating clinics, MetroPlusHealth has been committed to building strong relationships with its members and providers for over 30 years.

Responsibilities

• Reviews daily claims reports of varying focuses across all lines of business to identify and report on the accuracy of the pharmacy benefit configuration.
• Validates improper coding through verification between Point of Sales (POS) and Utilization Management (UM) platform systems.
• Coordinates care between members, pharmacies, and providers to improve patient adherence for chronic medications and to promote other pharmacy initiatives including assisting with pharmacy case management activities.
• Completes core and elective rotations.
• Affords opportunities to develop evidence-based clinical decision making, project management, analytic and leadership skills.

Requirements

• Doctor of Pharmacy required.
• Pharmacy experience in a managed care environment is preferred.
• Experience in auditing preferred.
• Experience in Pharmacy management of government programs (Medicaid and Exchange) preferred.
• Experience in the evaluation and interpretation of pharmacy claims data and other clinical data is preferred.
• Proficiency with MS Word, Excel, and PowerPoint is required.

Qualifications

• Minimum qualifications: Doctor of Pharmacy required.

Skills

• Excellent organizational, teamwork, interpersonal, time management, written and verbal communication skills.

Benefits

Not specified.

Pay

Not specified.

Schedule

9:00 AM - 5:00 PM