Position plans and leads activities for improvement relative to clinical, compliance and quality related initiatives within the Clinical Pharmacy department. Key activities include providing oversight on clinical pharmacy projects, establishing close working partnerships with peers and stakeholders across the enterprise to drive pharmacy quality results, and the execution of strategic action plans aimed at quality measure improvement.
Reports to: Director, Pharmacy Clinical Programs
Location: George Rd, Tampa, FL
- Serves as Subject Matter Expert (SME) for pharmacy quality measures (HEDIS, Stars, etc.), including validation of data presented at corporate committees in conjunction with corporate quality analytics team.
- Applies a comprehensive knowledge of clinical pharmacy and pharmacy quality management programs to drive results.
- Creates and implements clinical workflows, policies and procedures aimed at quality improvement goals.
- Develops, maintains, reviews, and oversees federal and/or state requirements and reporting functions of assigned clinical projects, and drives performance through partnership, leadership and open communication.
- Collaborates with other departments cross functionally regarding pharmacy quality star measure improvement plans.
- Presents pharmacy quality measure updates to key stakeholders within the markets (weekly, monthly, quarterly and annually via conference call, in-person presentations and metric reporting).
- Implements and oversees various project management functions and works with appropriate individuals across the organization to ensure successful completion (clinical projects, medication/disease states, Pharmacy quality).
- Develops, implements, and manages process improvement initiatives.
- Attends and presents at various department and corporate meetings. Prepares presentations for monthly, quarterly and annual meetings.
- Acts as a liaison between pharmacy and corporate compliance to ensure that all compliance related requirements are documented and develops CAPs if deficiency in assigned clinical processes is noted.
- Ensures policies and procedures in designated clinical area are reviewed, updated and presented to appropriate parties. This includes uploads to corporate site (C360) as assigned.
- Writes initial draft of clinical communications and works with corporate communications departments to ensure that all department area specific communications are updated and posted in a timely fashion.
- Reviews educational materials and assists with user education as needed.
- Sources new intervention vendors for quality measure improvements and makes recommendations to pharmacy leadership team. Partners with Director for vendor oversight as assigned.
- Participates in pharmacy quality alliance (PQA) to gather industry intelligence on pharmacy quality metrics.
- Performs other duties as assigned.
- Required A Bachelor's Degree in Pharmacy
- Preferred A Doctor of Pharmacy (PharmD)
- Required 5 years of experience in a licensed Pharmacist role, OR completion of PGY-1 residency program 2 additional years licensed Pharmacist role upon completion
- Required 2 years of experience in Managed Care Pharmacy Stars ratings / Quality metrics experience
- Required 1 year experience in leading/supervising others
- Required Other data analytics experience, preferably in a pharmacy environment
Licenses and Certifications:
- Intermediate Ability to communicate and make recommendations to upper management
- Intermediate Ability to effectively present information and respond to questions from peers and management
- Intermediate Ability to influence internal and external constituents
- Intermediate Ability to lead/manage others in a matrixed environment
- Intermediate Ability to drive multiple projects
- Advanced Demonstrated interpersonal/verbal communication skills
- Advanced Demonstrated written communication skills
- Intermediate Demonstrated project management skills
- Intermediate Knowledge of healthcare delivery
- Advanced Other ability to use pharmaceutical and medical reference / literature to provide drug information to the health plan
- Intermediate Other Ability to source quality measure intervention vendors for presentation to key leadership
A license in one of the following is required:
- Required Licensed Pharmacist
- Preferred Other Board Certification (i.e. BCPS) or other designations (i.e. CGP)
- Required Advanced Microsoft Excel
- Required Intermediate Microsoft Outlook
- Required Intermediate Microsoft Word
- Required Intermediate Microsoft PowerPoint
- Required Intermediate Healthcare Management Systems (Generic)