Pharmacy Utilization Management Coordinator *Hybrid – Boynton Beach, FL*

Position Summary:

We have an exciting opportunity to join our team as a Pharmacy Utilization Management Coordinator.

In this role, the successful candidate, the 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.

Job Responsibilities:

• 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.
• Visit practices on a 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 a 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 the 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.
• Demonstrate knowledge of the organization’s Service Standards and incorporate them into the performance of duties.
• Coach, mentor, and precept pharmacy students and residents.
• Seek professional development opportunities and participate 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 an Unrestricted Registered Professional Pharmacist license in Florida (required). Must obtain an unrestricted Registered Professional Pharmacist license in New York within 6 months of hire date.
• 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:  Pharm License – FL, Pharmacist License-NYS

Preferred Qualifications:
Pharmacy residency

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Florida 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 Florida’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.