Clinical Pharmacist
2 weeks ago
100% Remote position
About the Role:
This position serves as an internal and outward facing, dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and expectations.
Responsibilities:
Oversee daily clinical activities related to Star/HEDIS measure goals for various health systems to ensure clinical goals and objectives are met.
Serve as a clinical liaison between pharmacy department and health systems, assisting with managing overall relationships and driving adoption of recommended clinical solutions.
Develop, review, and monitor clinical programs, therapeutic initiatives, pathways of care, and other drug use policies and practices in support of Star/HEDIS initiatives.
Maintain continuity among health systems by communicating and documenting program design and execution in accordance with pharmacy department expectations.
Develop and track appropriate metrics to monitor the quality, care, and cost impact of the Star/HEDIS program and monitor overall healthcare trends within the Medicare populations.
Conduct member, provider, and pharmacy outreach/interventions and Comprehensive Medication Reviews as needed to achieve Stars goals.
Education Qualification:
BA/BS in Pharmacy or PharmD
Experience: 2 to 5 years
Experience in health plan or Medicare clinical customer service or retail management position
Project management experience and knowledge of health plans or Medicare industry
Familiarity with CMS Star/HEDIS measure quality improvement metrics
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