Clinical Pharmacist
5 days ago
Newark
Job Description Hybrid role in Newark, NJ commutable by bus and train to Newark, Penn Station These positions will support our Medication Therapy Management program and the Stars Medication Adherence Programs. The pharmacists will be supporting high touch outreach to members to complete annual comprehensive medication reviews and close medication adherence gaps. This is a highly telephonic outbound call position with much of the day spent making outbound calls to members, pharmacies, and providers This position serves as internal and outward-facing, dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and expectations, 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 stake holders 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 pharmacist 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., • Identify problems related to Star/HEDIS measures that require a clinical solution, implement and monitor clinical pharmacy solutions in support of Horizon’s Star/HEDIS goals to save money and improve care. Major responsibility is to serve as clinical liaison between Horizon pharmacy department and health systems, assisting with managing overall relationship and driving adoption of recommended clinical solutions., • 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 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.., • With support of the Horizon data team, develop and track the appropriate metrics to monitor the quality, care, and cost impact of the Star/HEDIS program and monitor overall healthcare trends within the Medicare populations., • 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. Knowledge: CMS Star/HEDIS measures Computer Skills: Microsoft Office Suite, access, excel, project management, power point