Quality Performance Clinical Pharmacist

Centene Management Company • New York City, NY

2d • Remote

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 also involves providing clinical and quality expertise to health plans and provider partners, developing and presenting performance reviews to address pharmacy chapter quality performance, strategizing and coordinating market and enterprise pharmacy chapter measure initiatives, identifying areas of opportunity for internal and external partners' operations, and facilitating communication, understanding, and training around enterprise pharmacy quality initiatives.

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.
• Candidates must reside in the Brooklyn, Jamaica, or Queens areas.
• 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.
• PHARM-R - Registered Pharmacist Current state with no restrictions Upon Hire required.

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.
• 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
• holidays
• 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