Location
Washington, DC, United States
Posted on
Nov 23, 2020
Profile
Description
The RX Clinical Programs Lead is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The RX Clinical Programs Lead develops strategies to improve plan quality, is the enterprise subject matter expert for medication related Star measures, and is responsible for ideation, implementation, and execution of new initiatives. The Rx Clinical Programs Lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action.
Responsibilities
Responsibilities
Develops clinical and business strategies designed to improve plan quality and Star ratings.
Enterprise subject matter expert for medication related Star measures (measure specifications, industry trends, CMS guidance, etc.).
Collaborates with analytics and/or research functions to project how initiatives will impact quality and Star ratings.
Drives the creation of analytics tools for effective monitoring of Stars performance.
Collaborates with multidisciplinary teams and key stakeholders across the enterprise to develop relationships, define business scope, and implement innovative programs.
Presents confidently to senior leadership on key metrics including financial impact to Humana and Star performance.
Responsible for program engagement and collaboration with vendor(s) and ensures effective working relationship(s) resulting in achievement of overall goals and performance metrics.
Responsible for financial management of the program budget.
Industry thought leader with active participation in external pharmacy quality organizations.
Required Qualifications:
Pharmacy Degree from an accredited School of Pharmacy
Clear and active Pharmacist license in the state(s) in which you are required to practice
8 years of clinical experience in managed care or pharmacy related field, or equivalent
2 years in project management or leadership experience
Proficiencies in Microsoft Office applications (especially Word, Excel, and PowerPoint)
Preferred Qualifications:
Stars program management experience (e.g. measurement specification and CMS quality policy knowledge)
Board Certified Pharmacist (e.g., BCACP, BCGP, BCPS, BCOP, BCPP)
Accredited Pharmacy Practice Residency
MHA, MBA, and/or demonstrated business background
Scheduled Weekly Hours
40
Company info
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