Posted: 07/17/18 | SHARE:


Provides oversight, leadership and guidance for the clinical operational programs within the Pharmacy department. Responsible for directing all aspects of the daily operations of the clinical pharmacy programs, including but not limited to coverage determination process, drug utilization management, and high-risk medication monitoring. Direct supervisory, training, performance management and evaluation responsibility for the clinical pharmacists and/or support staff supporting the coverage determination and other clinical management programs. Serve as key clinical support member for reviewing and solving complex clinical situations, including escalated member and provider issues, regulatory inquiries, and system application requirements. Monitor and ensure clinical and operational performance goals are maintained. Assures compliance with MVP, local, state and federal regulatory and accreditation requirements, including turnaround time monitoring and handling of coverage determination requests. Assist in the development, implementation, communication, training, and monitoring of new and existing clinical pharmacy programs to maximize resources, improve operational efficiencies, and minimize and prevent compliance risks. Develop, review and update departmental policies, process workflows, and training and evaluation documents. Serves as a resource to internal and external customers regarding clinical pharmacy programs and drug information. Represents department on internal committees and projects/initiatives as assigned. Supervise and mentor pharmacy students and interns as required. Assist with departmental audits and quality improvement activities. Position will require regularly scheduled on-call weekend rotations. Performs special projects and other duties as assigned. May require travel.




Minimum Education:

BS degree in Pharmacy or Pharm. D.; Current registration and licensure by New York State Board of Pharmacy or ability to obtain licensure prior to employment.


Minimum Experience:

Minimum of 5 years as a licensed, practicing pharmacist in a non-dispensing practice or 7 years in a combination of dispensing/non-dispensing clinical practice.

Minimum of 2 years managed care pharmacy and/or pharmacy benefit management (PBM) or managed care residency required.

Prior supervisory or leadership role required. Specialty BCPS certification preferred.


Required Skills:

• Ability to work well in a team environment with internal and external staff, practitioners and members.

• Excellent customer service skills and ability to deal with stressful situations in a calm and diplomatic manner.

• Strong leadership skills with demonstrated success in building an effective, collaborative, diverse team.

• Exceptional organizational and strong written and verbal communication skills.

• Exceptional clinical skills and ability to independently apply sound clinical judgement to a variety of situations.

• Strong analytical skills with the ability to interpret evaluate and act on data.

• Superior attention to detail and time management skills.

• Intermediate MS Word and MS Excel skills.

• Familiarity with healthcare benefits, pharmacy and medical terminology, and pharmacy claims adjudication process.

• Experience with regulatory entities such as CMS, DOH, DFR, NCQA, HEDIS, etc.

• Ability to sit at a workstation for long periods of time in front of a computer.


 To apply

Candidates must apply on-line at to be considered for a position with MVP.




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