Your Future is our Future
At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.
Position:
Clinical Pharmacy Director - Part D Stars
Position Summary:
As the Clinical Pharmacy Director – Part D Stars, you will play a pivotal role in enhancing the health and wellbeing of Medicare beneficiaries by leading innovative initiatives that directly improve clinical outcomes and patient experiences. You’ll be the driving force behind programs that optimize medication management, close adherence gaps, and empower seniors to live healthier lives all while steering your teams and partners towards achieving a coveted 5-Star quality rating.Harnessing your deep clinical expertise, you will proactively identify trends and unmet needs within our diverse member population, crafting and executing strategies that make a real difference in medication safety, chronic disease management, and overall care quality. Through strong partnerships with clinical and pharmacy teams, providers, and external collaborators, you will help ensure that every member receives high-value, evidence-based pharmacy care, thus improving patient outcomes across the board.
Job Description:
Primary Responsibilities
- Serve as a Part D Stars subject matter expert - provide clinical guidance and recommendations to enhance member outcomes, medication adherence, and overall health plan performance related to Part D Star measures
- Develop, recommend and implement Part D Stars operational strategy and roadmap
- Analyze, interpret, and enhance Part D Stars data and other pharmacy utilization reporting to identify areas for improvement and develop action plans to drive performance improvement
- Develop provider focused education and best practice content to be used in external partner meetings that drive improvement in Part D Stars and pharmacotherapy utilization optimization which supports safe and effective medication use
- Collaborate with cross-functional teams, including but not limited to provider services, quality, data analytics, pharmacy operations to ensure alignment and execution of Part D Star improvement initiatives
- Participate in oversight of Part D Stars vendors and identify new partnership opportunities
- Clearly articulate progress, achievements, and opportunities related to Part D Star measures to key stakeholders
- Assists in the development and review of pharmacy utilization reports targeted at physician group level and physician-specific level. Makes recommendations on ways to optimize pharmacotherapy utilization
- Trains pharmacy team members and other internal stake holders on Part D Star measures, initiatives, best practices and how to leverage target reporting to engage provider group partners. Guides and mentors team members to achieve departmental and company goals
- Collaborate closely with the VP, Clinical Pharmacy and Director, Pharmacy Operations to oversee and execute all pharmacy operations pertinent to Part D Stars and pharmacy benefit optimization
- Stay abreast of industry trends, regulatory changes, and best practices related to Part D Star measures and quality improvement
- Performs special projects as assigned
Qualifications
- Doctor of Pharmacy (PharmD) with a valid, registered pharmacy license in good standing
- Five (5) or more years of Managed Care experience or relevant clinical experience or the knowledge, skills, and abilities to succeed in the role
- Three (3) or more years of Medicare Advantage HEDIS/Stars experience
- Board certification in one or more of these areas of focus: Board Certified Pharmacotherapy Specialist (BCPS), Board Certified Ambulatory Care Pharmacist (BCACP) and/or Board-Certified Geriatric Pharmacist (BCGP)
- Experienced in leading projects that consistently achieve desired results with the ability to organize, prioritize, multi-task, and delegate tasks effectively
- Demonstrated ability to communicate effectively with diverse stakeholders and collaborate cross functionally
- Proactively identifies opportunities for improvement and takes ownership of solutions
- Adept at tailoring complex medication information from various sources (ie: prescription, OTC, herbal) to patients and other healthcare professionals in a clear, concise, and accessible manner
- Coached and mentored team members to enhance their skills and performance
- Creative thinker with strong judgment and motivation to problem solve
- Self-starter, possessing willingness and ambition to work through ambiguity
- Experienced in managing, analyzing and interpreting data sets with the ability to articulate actionable recommendations based on findings
- Strong computer skills including Microsoft Office
- Gifted public speaker and polished presentation style
Preferred
- Clinical experience in ambulatory care
- Completion of an ASHP Accredited PGY-1 Pharmacy Residency
- Experience using Electronic Medical Records (EMR), such as EPIC or AllScripts
Working Conditions
- While performing the duties of this job, the employee works in normal office working conditions.
#LI-Remote
Pay Transparency:
Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.
The hiring range for this position is:
Benefits of working at Lumeris
- Medical, Vision and Dental Plans
- Tax-Advantage Savings Accounts (FSA & HSA)
- Life Insurance and Disability Insurance
- Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
- Employee Assistance Program
- 401k with company match
- Employee Resource Groups
- Employee Discount Program
- Learning and Development Opportunities
- And much more...
Be part of a team that is changing healthcare!
Member Facing Position:
Location:
Remote, USA
Time Type:
Full time
Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.
Disclaimer:
- The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.
Lumeris is an EEO/AA employer M/F/V/D.
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