Clinical Pharmacy Program Specialist/CPT preferred-REMOTE

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Job Description

This position is responsible for the management of programs. It requires extensive knowledge of medications, disease states, pharmacy sig codes, and extensive knowledge of quality, pharmacy, and medical services. Additional responsibilities include communications with patients, pharmacists, interns, clients, and vendors. Responsible for ensuring all client and quality targets are being met.

Responsibilities

• Maintain required documentation for all activities and medication recommendations.
• Through collaboration with IT and analytics departments, develop and track the appropriate metrics to monitor the quality, and effectiveness of programs.
• Develop and enhance current reporting metrics to provide continuous quality improvement efforts.
• Generate outcomes reporting using outreach activity reports and pharmacy/medical data for direct client deliverables.
• Collaboratively work with clients, providers, and pharmacists to ensure optimal pharmaceutical care.
• Maintains HIPAA standards and confidentiality of protected health information.
• Generate and enhance clinical outreach materials to maximize program results.
• Assist and participate in meeting company and department goals such as quality improvement activities.
• Ensure the team is compliant with CMS requirements, HIPAA, and Fraud Waste and Abuse.
• Audit the program processes to ensure all documentation is appropriate and CMS compliant.
• Communicate effectively with the Clinical Pharmacy Team to address any ongoing issues or problems.
• Coordinate with multiple vendors to drive results in a timely manner.
• Utilize medical claims expertise to identify new areas of opportunity for specialty clinical programs.
• Generate detailed program outcomes data by analyzing pharmacy and medical data.
• Other duties as assigned.

Education & Experience

• Education Level
  • A Combination of Education and Work Experience May Be Considered.
  • Bachelors
• Required
  • Yes
• Fields of Study

• Experience Level
  • 2+ years
• Required
  • Yes
• Details
  • Healthcare

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

• Bachelor's degree required with 3 years' healthcare experience. May consider an additional 4 years of relevant experience (for a total of 7 years of experience minimum) in lieu of Bachelor's degree.
• Ability to develop and operationalize policies and procedures.
• Must be extremely detail oriented and very organized.
• Ability to work in a high stress environment and manage multiple complex responsibilities.
• Exceptional written and verbal communication skills.
• Superior analytical, organizational and problem solving skills.
• …