Pharmacy Programs Specialist - Full-Time - CPhT - Remote
We a dynamic and innovative healthcare organization dedicated to improving the health and well-being of our members. We are seeking a talented and driven Pharmacy Programs Specialist to join our team. If you are passionate about making a positive impact on members' lives and thrive in a fast-paced, evolving environment, we want to hear from you.
Responsibilities: As a Pharmacy Programs Specialist, you will:
- Create, manage, and respond to cases, escalating as necessary to Clinical Pharmacists on the team.
- Contribute to improving Part D Star measures by identifying and addressing root causes of medication management problems.
- Represent the Pharmacy team in cross-functional meetings and collaborate on initiatives that align with business goals.
- Collect and present data and trends from Pharmacy Benefits Manager (PBM) delegated functions to propose process improvements.
- Provide guidance on pharmacy clinical and regulatory workflows, policies, and processes to internal and external teams.
- Act as a liaison between the PBM Account Management Team and Clover Health, escalating issues as needed for resolution.
- Organize pharmacy team meetings with internal and external partners.
- Prioritize and strategize completion of quality assurance projects, distributing work to peers when necessary.
- Lead educational training sessions on Part D knowledge and vendor platforms for cross-functional teams.
- Play a critical role in CMS data validation audits, focusing on the Medication Therapy Management Program (MTMP).
- Work with tools and platforms to complete task/queue-based assignments efficiently.
- Communicate issues to the pharmacy leadership team in a timely manner.
- File, review, and validate reports to ensure compliance with Medicare guidelines.
- Gather and analyze data to improve clinical pharmacy quality metrics.
- Participate in training and orientation of new team members.
- Execute other job duties as assigned.
- National Certification (CPhT) preferred.
- Pharmacy Technician License (CPhT) preferred.
- At least three years of experience working in pharmacy, managed care organization, medical office, or hospital setting.
- Fluent in Spanish.
- Understanding of managed care principles.
- Proficient in Windows-based applications.
- Excellent written and oral communication skills.
Why You'll Love This Job:
- Opportunity to make a positive difference in members' lives.
- Fast-paced and innovative work environment.
- Strong emphasis on teamwork and collaboration.
- Ongoing learning and professional development.
- Competitive compensation and benefits package.
If you are a proactive and adaptable individual who is passionate about healthcare and ready to take on a challenging yet rewarding role, we encourage you to apply by sending your resume to [email protected]. Join our team and help us shape the future of healthcare.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled