Position Summary:

• This role serves as a dedicated clinical resource, responsible for supporting quality measures within the pharmacy department, specifically focusing on Star Ratings and HEDIS performance.
• The Clinical Pharmacist will lead, manage, and monitor clinical initiatives aimed at achieving optimal Star Ratings, with a goal of reaching and maintaining a 5-star performance.
• This position plays a key role in coordinating with internal stakeholders, vendors, health systems, and pharmacy partners to deliver measurable outcomes across Medicare Part D and other quality programs.

Pay Range: $40 - $46

Key Responsibilities:

• Lead and manage outreach efforts and clinical program execution for Medicare Part D Star measures including Adherence (Diabetes, RAS, Statins), SUPD, and CMRs for MTM services.

• Oversee clinical performance initiatives related to Star/HEDIS measures in collaboration with health systems and pharmacy partners; ensure that targets are met and sustained.

• Identify and resolve barriers impacting Star/HEDIS measures through the development, implementation, and monitoring of clinical pharmacy solutions.

• Serve as a clinical liaison between the pharmacy department and healthcare delivery systems to support adoption of evidence-based solutions aligned with performance goals.

• Develop and manage clinical programs, therapeutic initiatives, and medication use policies that support Star/HEDIS metrics, ensuring alignment with broader organizational objectives.

• Collaborate with internal teams to analyze, track, and report program performance metrics related to patient interventions, medication adherence, and disease management outcomes.

• Participate in direct member, provider, and pharmacy outreach and conduct Comprehensive Medication Reviews as needed to support Stars goals.

• Ensure cross-departmental communication and alignment regarding program goals, execution strategies, and clinical outcomes.

• Evaluate the financial and strategic impact of all clinical interventions, with a focus on optimizing healthcare quality, efficiency, and member satisfaction.

Note:
This description outlines the general scope of responsibilities and expectations for this role. It is not intended to be an exhaustive list of all duties, skills, or qualifications required.