Admin/Clerical - Clinical Pharmacist
Posted on :
14-10-2022
Employer Active
1 Vacancy
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Job Description
Req ID : 1710177
This position serves as an internal and outward-facing, dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and expect and developing and managing initiatives to achieve 5 stars.
The position has oversight responsibilities driven by metrics to manage vendors, retail pharmacy, prime, Magellan and health systems to deliver outcomes as outlined in different programs as well as reporting to internal stakeholders
Major Responsibilities (4 to 8 in total).
Major Responsibilities (4 to 8 in total).
The information above is intended to describe the general nature of the work being performed by each incumbent assigned to this position. This job description is not designed to be an exhaustive list of all responsibilities, duties, and skills required of each incumbent.
Duties and Responsibilities:
- Clinical pharmacist will be responsible for managing outreach efforts and pull-through for Star/HEDIS clinical programs. Coordinate between the pharmacy department, health systems, and Magellan.
- Clinical pharmacists will be responsible for driving results to obtain 5-Stars for Medicare Part D Star clinical programs including Adherence (DM, RAS, Statins), SUPD, and CMRs for MTM.
- Oversee the daily clinical activities related to Star/HEDIS measure goals for various health systems. Ensure clinical goals and objectives are met.
- Develop, review and monitor clinical programs, therapeutic initiatives, pathways of care, and other drug use policies and practices in support of Star/HEDIS initiatives. Works closely with the pharmacy department managers, vendors, and health systems to ensure the execution of programs.
- Maintain continuity among health systems by communicating and documenting program design and execution in accordance with pharmacy department expectations. Track, analyze, and report on patient interventions, interactions, and findings of disease management activities.
- Conduct member, provider, and pharmacy outreach/interventions and Comprehensive Medication Reviews as needed to achieve Stars goals.
- The position requires communication across all departments; an understanding of the strategic impact of the programs; and extensive knowledge of how the Star/HEDIS programs integrate with other clinical initiatives.
- Understand the financial impact of all clinical recommendations: Programs must address the impact on customers, operations, program integrity, pricing, quality, and satisfaction.
Qualifications
Education/Experience: BA/BS in Pharmacy or PharmD
Field(s) of study: Pharmacy
Experience: 2-5years
Experience: Health plan or Medicare clinical customer service or Retail management position. Project management experience and knowledge of health plans or the Medicare industry. CMS Star/HEDIS measures quality improvement metrics.
Industry: Healthcare; preferably with retail or health insurance provider.
Additional licensing, certifications, and registrations: A current Pharmacist license in the state of New Jersey
Knowledge: CMS Star/HEDIS measures.
Skills and Abilities:
- Able to receive assignments in the form of high-level objectives and independently establish detailed goals to meet objectives. Strong interpersonal skills.
- Excellent oral and written communication skills.
- Ability to function independently and as a team member.
- Good organization and time management, with the ability to manage multiple tasks.
- Proven ability to plan, organize, schedule, direct, control and monitor project activities.
- Able to perform basic financial analysis.
- Ability to interact at a high level with external contacts.
- Develop reporting and tracking documents with visuals
Computer Skills: Microsoft Office Suite, access, excel, project management, power point
ATD Technology, LLC is a certified minority woman owned business that creates opportunities to match qualified individuals with client programs while meeting all parties' financial and technical goals. ATD is a full service provider with offerings in Contract, Permanent and Temp-to-Perm staffing solutions. We serve Fortune 1000, mid cap and small cap companies in the Commercial, Public and Government sectors.
Employment Type
Full Time
Key Skills
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