Logo of Huzzle

Home

Matches

Explore

Manage

Pharmacy Intern

image

MetroPlusHealth

May 18

  • Internship
    Full-time
    Off-cycle Internship
  • Healthcare
  • New York

AI generated summary

  • You must have a Doctor of Pharmacy with experience in a managed care environment, auditing, and pharmacy management of government programs. Licensure in New York and proficiency in MS Word, Excel, and PowerPoint are required, along with excellent communication and organizational skills.
  • You will review claims reports, coordinate patient care, assist with prior authorizations, develop drug monographs, analyze utilization, educate staff, and support pharmacy quality initiatives at MetroPlusHealth.

Requirements

  • Doctor of Pharmacy required.
  • Pharmacy experience in a managed care environment preferred.
  • Experience in auditing preferred.
  • Experience in Pharmacy management of government programs (Medicaid and Exchange) preferred.
  • Position requires excellent organizational, teamwork, interpersonal, time management, written and verbal communication skills.
  • Proficiency with MS Word, Excel, and PowerPoint is required. Experience in the evaluation and interpretation of pharmacy claims data and other clinical data is preferred.
  • Position requires excellent organizational, teamwork, interpersonal, time management, written and verbal communication skills
  • Eligible for licensure in the state of New York (active and not limited Pharmacy Intern License plus Doctor of Pharmacy Degree)
  • Professional Competencie:
  • Integrity and Trust
  • Customer Focus
  • Functional/Technical Skills
  • Position requires excellent organizational, teamwork, interpersonal, time management, written and verbal communication skills

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.
  • Reviews daily rejection reports to identify and report on inconsistencies or concerns that may impact patient care.
  • Validates improper coding through verification between POS and 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.
  • Reviews daily reports to ensure all overrides are inputted correctly and claim adjudication is as intended.
  • Assists in preparing documentation for internal and external audits and regulatory submissions.
  • Reaches out to members, pharmacies, and prescribers to reconcile benefit inconsistencies.
  • Reviews external communications for accuracy and appropriateness.
  • Assists with prior authorization requests including, inputting, providing notification for and reviewing needed.
  • Complete core and elective rotations
  • Assists with formulary and utilization management for medications across all lines of business.
  • Develops drug monographs and coverage criteria upon request.
  • Completes retro utilization review for drugs of interest and provides in depth analysis.
  • Develops and maintains various pharmacy quality initiatives and generates regular monthly reports for key performance indicators.
  • Provides education to staff on new therapies, new criteria, new guidelines to ensure internal pharmacy staff are versed on up to date trends.
  • Assists in Pharmacy case management programs to improve quality of care and monitoring of MetroPlusHealth members.
  • Assists in organizational and departmental quality improvement initiatives

FAQs

What is the primary responsibility of a Pharmacy Intern II?

The primary responsibility of a Pharmacy Intern II is to audit and validate internal and external reports to ensure proper benefit configuration across all lines of business, while also assisting in other Pharmacy department directives.

What specific tasks will the Pharmacy Intern II perform related to formulary management?

The Pharmacy Intern II will assist the Clinical Pharmacy Manager with all aspects of formulary management, care management, and utilization management strategies across all lines of business.

How does the Pharmacy Intern II contribute to patient care?

The Pharmacy Intern II contributes to patient care by improving various clinical programs, conducting medication reconciliation, providing counseling, and participating in care management through rotations.

What skills can a Pharmacy Intern II expect to develop during their internship?

A Pharmacy Intern II can expect to develop evidence-based clinical decision-making, project management, analytic, and leadership skills.

Will the Pharmacy Intern II work independently or as part of a team?

The Pharmacy Intern II will likely work as part of a team, assisting the Clinical Pharmacy Manager and collaborating with other Pharmacy department staff.

What kind of experience or background is typically required for this position?

While the specific experience or background can vary, candidates are generally expected to be currently enrolled in a Pharm.D. program or have relevant educational qualifications in pharmacy.

Does this internship involve rotations, and if so, what is their purpose?

Yes, this internship involves rotations, which are designed to provide practical experience in various aspects of clinical care management and enhance the intern's skill set.

Is there an opportunity for the Pharmacy Intern II to participate in projects?

Yes, the Pharmacy Intern II will have opportunities to engage in projects that will help develop their project management and analytic skills.

What type of work environment can a Pharmacy Intern II expect?

A Pharmacy Intern II can expect a dynamic work environment that includes collaboration with healthcare professionals and engagement with clinical programs and patient care initiatives.

MetroPlusHealth

Ranked #1 Health Plan by New York State.

Science & Healthcare
Industry
1001-5000
Employees
1985
Founded Year

Mission & Purpose

Since 1985, MetroPlusHealth has helped the people of New York City get quality health care at little to no cost. MetroPlusHealth is the plan of choice for over 712,000 New Yorkers, and its commercial and government-sponsored plans meet the needs of individuals, families, and workforces. The MetroPlusHealth staff speaks more than 40 languages and is as diverse as the great City it serves. MetroPlusHealth is part of NYC Health + Hospitals, the nation's largest public health system. For more information, visit metroplus.org. Join the conversation on social media at @metroplushealth. Our Mission: We provide a caring, high-quality customer experience to preserve and improve the health and lives of New Yorkers with our integrated healthcare system. Our Vision: To be the number one plan of choice for the communities we serve. Our Core Values: Be caring and compassionate to all Be customer-powered: Align daily actions to positive, impactful customer experiences; connect with internal and external customers Be proud of what we do: Take ownership and accountability; be solutions driven Act as a team: Build trust, empower others, and champion transparent communication Thrive with change: Spark and support innovation, and transform our business through technology and data