Quality Performance Clinical Pharmacist

Centene Corporation • New York, NY

5d • Hybrid

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. This is a hybrid role requiring approximately 50% travel to local providers, along with onsite responsibilities. Candidates must reside in Queens, NY or within a short commute. Chinese or Spanish speaking candidates are strongly preferred. Position Purpose: The Pharmacy Quality Performance Manager will partner with health plans to drive pharmacy performance with an emphasis on pharmacy quality measures. Cross discipline interfacing across internal teams and external provider group partners to accelerate pharmacy quality. Provide expertise in enterprise pharmacy quality initiatives Subject matter expert on pharmacy quality measures across LOBs (Medicare, Medicaid, Marketplace) Provide clinical and quality expertise to health plans and provider partners Develop and present performance reviews in tandem with provider facing teams to address pharmacy chapter quality performance across: members, providers, provider groups, H-Contract and States Strategize and coordinate between market and enterprise pharmacy chapter measure initiatives to ensure complimentary efforts Identify areas of opportunity for internal teams’ and external provider partners’ operations to accelerate pharmacy measure performance Facilitate communication, understanding and training around enterprise pharmacy quality initiatives to internal provider facing teams to extend the reach of quality performance impact Performs other duties as assigned Complies with all policies and standards

Requirements

• Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy required
• 3+ years of retail or hospital pharmacy experience or 1+ years of managed care pharmacy experience required
• Clinical pharmacy experience in a managed healthcare environment preferred
• Centene Pharmacy Services: 3+ years managed care pharmacy or pharmacy benefit management experience preferred
• PHARM-R - Registered Pharmacist Current state with no restrictions Upon Hire required
• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
• Candidates must reside in Queens, NY or within a short commute.

Nice To Haves

• Bilingual candidates (Chinese or Spanish) are strongly preferred.

Responsibilities

• Partner with health plans to drive pharmacy performance with an emphasis on pharmacy quality measures.
• Cross discipline interfacing across internal teams and external provider group partners to accelerate pharmacy quality.
• Provide expertise in enterprise pharmacy quality initiatives
• Subject matter expert on pharmacy quality measures across LOBs (Medicare, Medicaid, Marketplace)
• Provide clinical and quality expertise to health plans and provider partners
• Develop and present performance reviews in tandem with provider facing teams to address pharmacy chapter quality performance across: members, providers, provider groups, H-Contract and States
• Strategize and coordinate between market and enterprise pharmacy chapter measure initiatives to ensure complimentary efforts
• Identify areas of opportunity for internal teams’ and external provider partners’ operations to accelerate pharmacy measure performance
• Facilitate communication, understanding and training around enterprise pharmacy quality initiatives to internal provider facing teams to extend the reach of quality performance impact
• Performs other duties as assigned
• Complies with all policies and standards

Benefits

• Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees