Quality Performance Clinical Pharmacist
About The Position
The Pharmacy Quality Performance Manager will partner with health plans to drive pharmacy performance with an emphasis on pharmacy quality measures. This role involves cross-discipline interfacing across internal teams and external provider group partners to accelerate pharmacy quality. The position requires expertise in enterprise pharmacy quality initiatives and serves as a subject matter expert on pharmacy quality measures across various lines of business (Medicare, Medicaid, Marketplace). The role provides clinical and quality expertise to health plans and provider partners, develops and presents performance reviews with provider-facing teams to address pharmacy chapter quality performance, and strategizes and coordinates between market and enterprise pharmacy chapter measure initiatives to ensure complimentary efforts. It also identifies areas of opportunity for internal teams and external provider partners' operations to accelerate pharmacy measure performance and facilitates communication, understanding, and training around enterprise pharmacy quality initiatives to internal provider-facing teams to extend the reach of quality performance impact. The role performs other duties as assigned and 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.
- PHARM-R - Registered Pharmacist Current state with no restrictions Upon Hire required.
- Candidates must reside in the Houston, TX area.
- This is a remote role with travel of 50% or more to provider offices and community pharmacies.
- Candidates must be able to maintain a regular travel schedule within the assigned region.
Nice To Haves
- Clinical pharmacy experience in a managed healthcare environment preferred.
- 3+ years managed care pharmacy or pharmacy benefit management experience 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.
- Serve as a 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
- competitive pay
- health insurance
- 401K
- stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- a flexible approach to work with remote, hybrid, field or office work schedules.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
