Summary
This role is responsible for the performance of assigned quality measure programs, including Medicare Stars measures such as medication adherence and statin use. The role combines team leadership and hands-on support, overseeing a group of pharmacy technicians and care coordinators while actively participating in outreach and escalated cases. In this role, you will direct daily workflow, coach team members, and ensure effective execution of gap closure activities. A key focus of the role is analyzing program performance and driving improvements to achieve and maintain 5-star results. This position is ideal for someone who enjoys both leading people and working directly on meaningful clinical quality initiatives.
Program Leadership
- Own and drive the performance of assigned clinical programs, ensuring Medicare measures achieve 5-star levels.
- Take charge of team workflow, setting priorities and guiding staff to deliver results on key quality measures.
- Train, coach, and mentor pharmacy technicians and care coordinators, providing guidance to improve performance and deliver high-quality results.
- Monitor program metrics, analyze trends, and implement targeted interventions to address gaps in care and workflow inefficiencies.
- Manage escalated cases and quality issues, personally intervening when necessary to ensure timely resolution.
- Collaborate with leadership and program managers to coordinate efforts, address challenges, and meet program goals.
- Track program performance and communicate progress to leadership.
Member Outreach
- Lead initiatives to close clinical care gaps in assigned programs, such as medication adherence, statin therapy, and other related measures.
- Conduct outreach to health plan members, pharmacies, and healthcare providers to identify barriers and improve quality measure performance.
- Respond to pharmacy-related questions from members and client staff, resolving issues directly or escalating as appropriate.
General Responsibilities
- Foster a positive, professional, and safe work environment that promotes teamwork and high-quality service.
- Perform other duties aligned with program goals and responsibilities.
Benefits & Schedule
· Full-Time, in-office, Monday-Friday, 9:00am-5:30pm
· Medical, dental, vision, and life insurance
· 401(k) match eligible
· Performance bonus eligible
Pay: Up to $28.84 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Prescription drug insurance
- Retirement plan
- Vision insurance
Application Question(s):
- Are you willing to consent to random drug screens and complete a background check?
Experience:
- PBM, health plan, or retail pharmacy setting: 2 years (Preferred)
- Medicare Stars of HEDIS gap closure program: 1 year (Preferred)
- Excel for reporting or data analysis: 1 year (Preferred)
- lead, supervisor, or similar role: 1 year (Preferred)
License/Certification:
- Arizona Pharmacy Technician License (Preferred)
Ability to Commute:
- Glendale, AZ 85308 (Required)
Work Location: In person
