Pharmacy Quality Specialist

🔥 0 minutes ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $22 - $27 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Martin's Point Health Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🛡️ Insurance

📦 Logistics

💼 Consulting

Insurance • Logistics • Consulting

Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

📋 Description

• Run and review daily, weekly, and monthly reports to identify medication-related care gaps and opportunities associated with Medicare Stars, HEDIS, and other quality measures • Conduct telephonic outreach to members to identify medication adherence barriers and support timely access to prescribed medications • Educate members on prescription refills, medication access, pharmacy options, benefit resources, and assistance programs • Conduct outreach to provider offices and pharmacies to resolve medication-related quality gaps and facilitate timely interventions • Support pharmacy quality measures, including medication adherence, statin use, medication safety, and polypharmacy measures • Review pharmacy claims, medication histories, and available data to identify adherence concerns, refill opportunities, medication discrepancies, and quality measure gaps • Identify members requiring pharmacist clinical review and escalate concerns or interventions requiring professional judgment • Track quality opportunities from identification through outreach, intervention, follow-up, and resolution • Follow up with members, providers, and pharmacies to close identified care gaps • Document outreach and intervention outcomes in designated systems and tracking tools • Maintain logs, dashboards, reports, and tracking mechanisms monitoring quality measure performance and intervention outcomes • Support targeted campaigns and quality improvement initiatives • Collaborate with pharmacists and pharmacy leadership to identify trends, barriers, and improvement opportunities • Serve as a liaison among members, providers, pharmacies, pharmacists, and internal departments • Assist members with medication access barriers, refill coordination, pharmacy issues, and benefit questions • Support provider-facing initiatives and follow up on pharmacist or provider recommendations • Participate in pharmacy quality meetings, team huddles, and interdisciplinary meetings • Assist with special projects and process improvement initiatives related to pharmacy quality, member experience, and medication outcomes • Maintain knowledge of applicable quality measures, workflows, policies, procedures, and regulatory requirements • Perform other duties as assigned

🎯 Requirements

• High School Diploma or equivalent • Active Maine Pharmacy Technician license required prior to Martin's Point employment • 3 years of customer service experience required • Prior pharmacy or managed care pharmacy experience or exposure preferred • Knowledge of Medicare Part D, Stars, and HEDIS quality measures preferred • Familiarity with medication adherence strategies and population health workflows preferred • Proficiency with Microsoft Office/Excel • Strong communication, organizational, customer service, interpersonal, and collaboration skills • Superior written and verbal communication skills • Ability to adapt to changing priorities and work in a fast-paced environment • Ability to manage, prioritize, and complete multiple projects in a timely manner with limited supervision • Ability to handle confidential and sensitive information discreetly and professionally • Position is not eligible for immigration sponsorship

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Retirement savings with employer contributions • Paid time off • Volunteer time off • Pie day • Other employee benefits