Quality Performance Clinical Pharmacist

Centene Management Company•Houston, TX

14h•Hybrid

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 involves providing clinical and quality expertise to health plans and provider partners, developing and presenting performance reviews with provider-facing teams to address pharmacy chapter quality performance, and strategizing and coordinating between market and enterprise pharmacy chapter measure initiatives. Additionally, the role identifies opportunities for internal teams and external provider partners to improve operations and accelerate pharmacy measure performance, facilitates communication and training on enterprise pharmacy quality initiatives, and performs other duties as assigned while complying 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.
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.
Candidates must reside within a reasonable commuting distance of Houston, TX.
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.
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.