Clinical Pharmacist, Quality Programs Specialist

23 hours ago


Honolulu, Hawaii, United States HMSA Full time
Job Summary

We are seeking a highly skilled Clinical Pharmacist to join our team at HMSA. As a Clinical Pharmacist, Quality Programs, you will be responsible for developing and implementing pharmacy quality programs to improve patient outcomes and enhance the quality of care provided by our members.

Key Responsibilities
  1. Quality Program Development: Develop, implement, and maintain pharmacy quality programs to improve patient outcomes and enhance the quality of care provided by our members.
  2. Medicare STARS, Medicaid, and Commercial Programs: Support the development of strategies and interventions to improve quality scores for Medicare STARS, Medicaid, and Commercial programs.
  3. Collaboration and Communication: Collaborate with internal and external stakeholders to develop and implement quality programs, and provide guidance to deploy action plans for pharmacies, pharmacists, physician organizations, specialists, and Federally Qualified Health Centers.
  4. Program Outcomes and Measurement: Build, maintain, and measure program outcomes related to HEDIS and QRS measures.
  5. Subject Matter Expertise: Provide subject matter expertise for medication therapy management program, medication reconciliation, and medication reviews.
  6. Provider and Member Communications: Create provider and member communications related to clinical quality initiatives.
  7. Account Management and Sales Support: Support Account Management & Sales in product development and RFP responses.
  8. Initiative Evaluation and Enhancement: Evaluate and re-evaluate ongoing initiatives to assure they continue to provide value to the organization and its members.
  9. Utilization Management Strategies: Develop and enhance utilization management strategies.
  10. Strategic Partnership and Vendor Management: Provide oversight of strategic partnership relationships and vendor management to assure contract obligations and performance metrics are on track.
  11. Clinical Guidance and Communications: Provide clinical guidance for communications to the organization, members, providers, and vendors on formulary changes and initiatives.
  12. Committee Participation: Participate in the HMSA Pharmacy and Therapeutics Committee.
  13. Other Responsibilities: Perform all other miscellaneous responsibilities and duties as assigned or directed.


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