Pharmacy Programs Specialist

Job not on LinkedIn

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $53.8k - $70k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

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Clover Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

🛡️ Insurance

🤖 Artificial Intelligence

Healthcare • Insurance • Artificial Intelligence

Clover Health is a healthcare technology company helping members live their healthiest lives with our Medicare Advantage plans. Focused on seniors who have historically lacked access to affordable and high-quality healthcare, Clover aims to provide care sustainably by improving medical outcomes while simultaneously lowering avoidable costs. They leverage a proprietary software platform, the Clover Assistant, to aggregate patient data and offer real-time recommendations to healthcare providers. Their services include affordable Medicare Advantage plans, a home care program, and they manage care for Medicare Advantage members across several U. S. states.

📋 Description

• Create, manage, and respond to cases and escalate to Clinical Pharmacists as needed • Support Medicare Part D Star measures by resolving medication management problems and providing recommendations based on profile review or patient interview • Represent the Pharmacy team in cross-functional meetings • Collect and present PBM delegated-function data and trends to propose process improvements • Deliver cross-functional initiatives and ad-hoc projects • Provide guidance on pharmacy clinical and regulatory workflows, policies, and processes • Liaise between the PBM Account Management Team and Clover Health and escalate issues for resolution • Organize pharmacy team meetings with internal and external partners • Distribute work and strategize completion of quality assurance projects • Maintain and update Part D content in the internal knowledge base • Lead educational training on Part D knowledge and vendor platforms • Participate in call center quality assurance reviews • Perform strategic work to increase MTMP Star measure • Navigate tools and platforms for task/queue-based work • Serve as a resource to peers and complete program/project-based work • Communicate issues to pharmacy leadership • File, review, and validate reports for Medicare compliance • Gather data and generate reports to improve clinical pharmacy quality metrics • Participate in training and orientation of new team members • Execute other assigned duties

🎯 Requirements

• National Certification (CPhT) Pharmacy Technician License (preferred) • At least three (3) years of experience working in pharmacy, managed care organization, medical office or in a hospital setting • Fluent in English and Spanish, both orally and in writing • Understanding of managed care • PC skills in Windows-based applications • Excellent written and oral communication skills • Ability to work Eastern Time (ET) hours; candidates in this time zone preferred

🏖️ Benefits

• Competitive base salary • Equity opportunities • Performance-based bonus program • 401(k) matching • Regular compensation reviews • Medical coverage • Dental coverage • Vision coverage • No-Meeting Fridays • Monthly company holidays • Mental health resources • Generous flexible time-off policy • Remote-first culture • Learning programs • Mentorship • Professional development funding • Regular performance feedback and reviews • Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities • Reimbursement for office setup expenses • Monthly cell phone & internet stipend • Collaboration with global teams • Paid parental leave for all new parents