Clinical Pharmacy Manager - Transitional Care Excellence

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The Transitional Care Clinical Pharmacy Manager is a core clinical team member within Montefiore’s multidisciplinary Transitional Care Excellence department. This role sits at the intersection of inpatient care, ambulatory management, and population health, with a focus on improving outcomes for high-risk cardiovascular-kidney-metabolic and respiratory patient populations.

Responsibilities 

• Leads longitudinal pharmacotherapy management for a defined panel of high-risk patients with cardiovascular-kidney-metabolic syndrome and respiratory conditions during hospitalization and post-discharge utilizing telemedicine, remote patient monitoring, and in-person care models
• Initiates, optimizes, and titrates guideline-directed medical therapy (GDMT) under collaborative drug therapy management (CDTM) agreements, with a focus on heart failure, ASCVD, diabetes, obesity, CKD, COPD, asthma, and pneumonia.
• Identifies and acts on high-impact clinical opportunities early in the post-discharge period to prevent readmissions and disease progression
• Solves complex medication-related challenges including access, affordability, adherence, and health-related social needs
• Serves as a clinical bridge across inpatient, ambulatory, and post-acute settings, ensuring seamless care transitions and accountability across the continuum
• Partners with physicians, advanced practice providers, nurses, and navigators to design and execute high-reliability care pathways
• Acts as a key liaison to post-acute partners including home care, skilled nursing facilities, and rehabilitation centers
• Contributes to quality improvement initiatives aligned with CMS Star Ratings, HEDIS measures, and value-based care contracts
• Participates in program development, innovation (e.g., telehealth optimization, AI-enabled outreach, RPM workflows), and scaling of disease-specific care pathways
• Engages in academic and scholarly activities including research, protocol development, and dissemination of outcomes

Qualifications 

• Doctor of Pharmacy degree 
• Advanced training (e.g., completion of a PGY-2 residency in cardiology, ambulatory care, or other relevant specialties) or completion of a PGY-1 residency with current board certification and 3 years of relevant experience
• NYS license with eligibility to be credentialed as an allied health professional  
• Active Board of Pharmacy Specialties certification or completion within 6 months of hire
• Direct patient care experience in ambulatory, hospital, or transitional care settings.
• Strong clinical judgment, communication, and interdisciplinary collaboration skills.
• Experience managing chronic cardiometabolic or pulmonary disease states.
• Experience in value-based care, care transitions, or population health programs.
• Bilingual language skills preferred

Work Environment

• Position requires onsite presence during onboarding, credentialing, training, and orientation.
• Initial six-month probationary period will be fully onsite.
• Following successful completion of training, credentialing, and the six-month probationary period, employees may be eligible for limited telemedicine or remote work responsibilities based on operational needs.
• Candidates must be comfortable working in both ambulatory and interdisciplinary care settings.

The ideal candidate will demonstrate:

• Strong clinical pharmacy knowledge and direct patient care experience
• Ability to thrive in a fast-paced, complex healthcare environment
• Excellent problem-solving and critical-thinking skills
• Strong organizational and time-management abilities
• Adaptability and comfort navigating change and evolving priorities
• Commitment to delivering high-quality, patient-centered care
• Ability to collaborate effectively with physicians, nurses, advanced practice providers, and interdisciplinary teams
• Passion for improving outcomes for high-risk and vulnerable patient populations
• Strong communication and relationship-building skills
• Board certification (BCPS, BCACP, or equivalent) preferred, or willingness to obtain within the required timeframe