Join PacificSource and help our members access quality, affordable care. The Senior Clinical Pharmacy Strategist is responsible for helping improve, develop, and implement initiatives necessary to execute on PacificSource Clinical Pharmacy strategies and management priorities.
Requirements
- Track, analyze, and interpret quality metrics to identify gaps in care, improve outcomes and ascertain opportunities for improvement.
- Partner cross-functionally with Care Management, Utilization Management, Provider Network, and Medical Directors to design and deploy integrated quality performance programs to enhance member outcomes and provider engagement.
- Lead the creation and execution of clinical program strategies that align with organizational goals and advance STARS and HEDIS performance metrics through targeted pharmacy initiatives.
- Ensure programs comply with regulatory requirements and quality standards.
- Monitor and evaluate program performance, making data-driven adjustments as needed.
- Facilitate workgroups and committees to gather input and drive program development.
- Maintain a detailed understanding of all shared data elements (drug data including GPI, NDC, HCPC, and ICD-10 coding) and the systems necessary to support actionable interventions.
- Conduct outcome analyses to evaluate quality programs, initiatives and interventions utilizing multiple data sources to determine the effectiveness of activities and make recommendations to improve outcomes for CMS Stars, NCQA, QIM (HEDIS, CAHPS).
- Provide structured project management for clinical initiatives, ensuring timely and within-scope completion.
- Develop and manage within project timelines, budgets, and resources.
- Coordinate cross-functional teams to develop and deploy annual improvement plans with performance metrics, monitor risk, deploy mitigation strategies and elevate to joint operating committees as needed.
- Lead quality improvement initiatives to enhance patient care and safety.
- Supporting Responsibilities: Work with Clinical Pharmacy leadership to improve processes, systems, reporting, and services provided by the department.
- Support Clinical Pharmacy leadership by delivering actionable data analytics that inform enterprise cost-of-care strategies and monitor clinical team performance metrics, as assigned.
- Assists Leadership in the planning, development, and implementation of the clinical and operational processes for MTM Services within Medicare Part D products
- Represent Pharmacy Services Department, both internally and externally, as requested.
- Meet department and company performance and attendance expectations.
- Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
- Perform other duties as assigned.
Benefits
- Paid Time Off
- Health Insurance
- Retirement Plan
- Employee Stock Purchase Plan
- Recognition and Rewards
- Flexible Work Arrangements
