The preceptors participating in the Residency Program are passionate about their work and even more passionate about teaching the next generation of Managed Care Pharmacists. The preceptors carefully curate rotations during the time of year that would provide the maximum experience for our resident. Below is a list and a high level description of the rotations offered in our program. (Note: Assignments may change due to department needs). If you are interested in learning more, we will be showcasing at AMCP Nexus. If you are not able to make it, no worries! We will be hosting a LinkedIn Residency Showcase in November. Follow the Healthfirst page to find out more information on how to register for the event and learn more about our program!
Care ManagementThe resident will have the opportunity to engage with various Care Management teams to understand how nurses and social workers participate in, and facilitate, the care of our members.
This rotation provides the opportunity to observe the role a pharmacist plays in our fully integrated Complex Care HIV team and participate in the care and coordination of our members’ care. During the course of the residency year, the resident develops a strong relationship with the Case Management Department by presenting at least 2 Grand Rounds presentations and at least 1 topic presentation during the rotation.
Drug Information/ResearchAccess, interpret, and extract pertinent information from published literature to answer drug information requests and effectively communicate appropriate clinical information. A longitudinal research project will be conducted, where the resident will identify, design, and execute a practice-related research project. If conducting research in the Managed Care environment intimidates you, the preceptors are here to support you through the process. Based on the topic, the resident is set up with a lead preceptor to conduct the various stages of the project. The resident will prepare an abstract for acceptance and present a poster at a national meeting. At the conclusion of the residency year, the research project is required to be submitted in a publication-ready format.
LeadershipWork with executive leaders of the pharmacy department to understand the department planning process, financial management, and development of department specific goals to achieve corporate goals.
Work with the Residency Program Director (RPD) in the recruitment and selection of candidates for the following residency year.
Pharmacy Benefit Manager (PBM) Oversight: This rotation is split into various components:
Longitudinal PBM Oversight
Core PBM Oversight
During the Core PBM Oversight rotations the resident gains experience in managing the pharmacy benefits offered by Healthfirst’s various lines of business. Lines of businesses include Medicare, Medicaid, and Commercial plans.
Learn how these benefits are designed, monitored, and modified by Healthfirst and in partnership with our Pharmacy Benefit Manager.
Understand the department’s role in ensuring the benefit is provided in compliance with regulation set forth by the Centers for Medicare & Medicaid Services and the New York State Department of Health.
These rotations provide an opportunity for experience in monitoring the medication pipeline with 2 presentations during the residency year and 2 monograph presentations.
Medical Pharmacy - Utilization Management (UM)Become familiar with the management of high-cost drugs and how to identify future opportunities. Conduct a drug utilization review to present the Healthfirst Pharmacy Advisory Committee (HFPAC), develop drug criteria, and review prior authorization requests for specialty medications on the medical pharmacy benefit.
POPulation Health & Medication Therapy Management (MTM)Understand the major population health issues in the New York City metro area, including Social Determinants of Health and health disparities that affect the Healthfirst Medicare membership.
Work on potential programs and initiatives to resolve health-related barriers—such as medication non-adherence, access to care, and improving member health literacy—to enhance the overall quality of the health plan.
Become familiar with the foundations of an MTM program, understand CMS guidance for MTM, and administer Complete Medical Reviews (CMRs).
Provider Engagement During this unique rotation, the resident will have the opportunity to work with a team of pharmacists who have established strong relationships with hospital systems, provider groups, and community pharmacies to resolve health-related barriers (i.e. medication non-adherence and access to care) and promote member health literacy with the goal of improving overall quality of the health plan.
Regulatory and ComplianceBe introduced to State and Federal agencies’ regulatory and compliance requirements for Managed Care Organizations. Become familiar with Part C and D Enrollee Grievances Organizational Coverage Determination Appeals Guidance, the Medicaid Managed Care Model Contract, and how they affect policies and procedures.
Reporting and AnalyticsWork with our dedicated Enterprise Analytics team on various pharmacy related data evaluations and analytic requests. Learn how clinical decisions are derived from data using data tools and platforms (e.g. tableau, SAS), and manipulating data sets.
Teaching and AcademicsLearn the skills needed to effectively serve as a preceptor to pharmacy interns who complete their Advance Pharmacy Practice Experience (APPE) at Healthfirst. This includes onboarding students, facilitating necessary assignments, and evaluations.
Teaching Certificate ProgramEffective teaching is both an art and skill that is introduced in the Teaching Certificate program. Learn foundational knowledge to understand adult learners and how to effectively design and deliver content. The Teaching Certificate Program aids in attaining the skills needed to determine an audience’s educational need, capture their attention, and transmit information using various media.