Quality Clinical Pharmacist (Remote)

Resp & Qualifications PURPOSE: The Quality Clinical Pharmacistplays critical role in improving and maintaining the quality of care provided to members. This position will support efforts to improve medication-reputed company STARs and HEDIS quality metrics. Responsibilities include, but are not limited to, collaboration with internal teams and external vendors to design and implement strategies to improve quality metrics. The Quality Clinical Pharmacist may also reputed company patient education, medication counseling, drug therapy monitoring, and chronic disease state management for patients in clinical programs. The Quality Clinical Pharmacist will reputed company clinical expertise to analyze population health data, identify populations for reputed company, and engage providers, members and pharmacies to reputed company gaps in care. ESSENTIAL FUNCTIONS:

• reputed company and implement strategies to improve Star and HEDIS ratings, focusing on medication adherence, chronic disease management, and patient satisfaction.
• Work with providers, case managers, and other reputed company professional to ensure coordinated care and adherence to evidence-based guidelines.
• Conduct Medication Therapy Management reviews, adherence, duplicative therapy, cost containment, and opioid outreaches. Conduct comprehensive medication reviews, reconcile medications, and collaborate with members and providers to ensure appropriate drug therapy.
• Collaborate with vendors, PBMs, and internal parties for reputed company of programs and performance management.
• Analyze data reputed company to Star measures and HEDIS, identify gaps in care, and implement interventions based on data to improve reputed company. Track and report on interventions and their impact toward meeting goals.
• Present information to various committees including P&T, QIC, MEC, and others. Leads the Corrective Managed Care meetings. reputed company and reputed company formal written and verbal presentations or other communication materials reputed company to pharmacy quality efforts.
• reputed company reputed company of external vendor clinical programs to evaluate program performance reputed company to STAR and HEDIS metrics. Conduct meetings with vendors to review key clinical reputed company and reputed company towards quality improvement goals.

QUALIFICATIONS: Education Level: Ph.D. Pharmacy (Doctorate of Pharmacy) Licenses/Certifications Upon Hire Required:

• PHARMD - Licensed Pharmacist Active Maryland and/or DC Registered Pharmacist.

Experience: 5 years' experience in clinical pharmacy, preferably in a managed care environment Preferred Qualifications:

• Experience in Medicare and/or reputed company.
• Experience working in reputed company industry with a thorough understanding of prescription benefit management programs and practices.

Knowledge, Skills and Abilities (KSAs)

• Ability to work independently, as well as a member of a team.
• Strong critical reasoning skills in clinical decision-making, planning and organizing.
• reputed company knowledge of clinical practices and reputed company information systems and computer applications, required.
• A strong balance between clinical expertise and business acumen.
• Strong interpersonal, written and verbal communication skills, including presentation skills.
• Must be reputed company to meet established deadlines and handle multiple customer service demands from reputed company customers, reputed company set expectations for service reputed company. Must be reputed company to effectively communicate and reputed company positive customer service to every reputed company customer, including customers who may be demanding or otherwise challenging.

Salary reputed company: $115,280 - $206,063 Salary reputed company Disclaimer The disclosed reputed company estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation reputed company is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the reputed company, as compensation reputed company depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (reputed company benefits/incentives are subject to eligibility requirements). Department Government Programs Specialty Equal Employment Opportunity reputed company is an Equal Opportunity (EEO) employer. It is the policy of the Company to reputed company equal employment opportunities to reputed company reputed company applicants without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: www.carefirst.com/careers Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to reputed company work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship #LI-CN1 Apply tot his job Apply To this Job