Pharmacy Stars Improvement Lead
About The Position
The Pharmacy Stars Improvement Lead will be a part of a collaborative Pharmacy Stars team which is accountable for Humana's Stars patient safety measure performance. The Pharmacy Stars Improvement Lead will autonomously develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use with specific focus on telehealth and in-home methods of care delivery. The Pharmacy Stars Improvement Lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action.
Requirements
- Bachelor's Degree in Business, Finance, Health Care or a related field
- 2 or more years of project leadership experience
- Prior Medicare/Medicaid experience
- Strategic thinking and planning capabilities; organized and detail-oriented
- Excellent communication skills
- Enthusiasm and motivation essential; a confident change-agent; strong presentation skills (oral and written)
- Ability to operate under tight deadlines
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Self-provided internet service with at least 25 Mbps download and 10 Mbps upload speed.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Nice To Haves
- Medication prescribing and medical coding experience as PA, NP, or BSN preferred
- Master's Degree in Business Administration, Health Administration or a related field
- Progressive experience in the health solutions industry
- Provider relations experience
- Prior managed care experience
- Understanding of metrics, trends and the ability to analyze and identify gaps in care
- Proven organizational and prioritization skills and ability to collaborate with multiple departments a plus
- Understanding of CMS Stars, performance measures, HEDIS knowledge and experience a plus
- Background working in quality improvements
Responsibilities
- Develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use.
- Focuses on telehealth and in-home methods of care delivery.
- Exercises independent judgment and decision making on complex issues.
- Works under minimal supervision.
- Analyzes variable factors to determine the best course of action.
Benefits
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- Short-term disability
- Long-term disability
- Life insurance
- Bi-weekly payment for internet expense (for employees in California, Illinois, Montana, or South Dakota)
- Telephone equipment provided
- Bonus incentive plan
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
