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Quality Performance Clinical Pharmacist

Roles & Responsibilities

  • Bachelor’s degree or advanced degree (PharmD, M.S) in pharmacy required
  • 3+ years of retail or hospital pharmacy experience or 1+ year of managed care pharmacy experience required
  • Clinical pharmacy experience in a managed healthcare environment preferred
  • Licensed Pharmacist (PHARM-R) with a current state license and no restrictions upon hire

Requirements:

  • Partner with health plans to drive pharmacy performance focusing on pharmacy quality measures, with cross-disciplinary interfacing across internal teams and external provider groups to accelerate quality
  • Serve as subject matter expert on pharmacy quality measures across lines of business (Medicare, Medicaid, Marketplace) and provide clinical and quality expertise to health plans and provider partners
  • Develop and present performance reviews with provider-facing teams to address pharmacy quality performance across members, providers, provider groups, H-Contract, and states; coordinate with market and enterprise measure initiatives
  • Identify opportunities for internal and external partner operations to accelerate measure performance and facilitate communication, training, and adoption of enterprise quality initiatives

Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

This is a hybrid role with 50% travel required to local pharmacies. Qualified candidates must reside in one of the following states: TX, IL, MI, WI, NY, FL, GA, NC or CA

Position Purpose: The Pharmacy Quality Performance Manager will partner with health plans to drive pharmacy performance with an emphasis on pharmacy quality measures. Cross discipline interfacing across internal teams and external provider group partners to accelerate pharmacy quality.

  • Provide expertise in enterprise pharmacy quality initiatives
  • Subject matter expert on pharmacy quality measures across LOBs (Medicare, Medicaid, Marketplace)
  • Provide clinical and quality expertise to health plans and provider partners
  • Develop and present performance reviews in tandem with provider facing teams to address pharmacy chapter quality performance across: members, providers, provider groups, H-Contract and States
  • Strategize and coordinate between market and enterprise pharmacy chapter measure initiatives to ensure complimentary efforts
  • Identify areas of opportunity for internal teams’ and external provider partners’ operations to accelerate pharmacy measure performance
  • Facilitate communication, understanding and training around enterprise pharmacy quality initiatives to internal provider facing teams to extend the reach of quality performance impact
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy required
3+ years of retail or hospital pharmacy experience or 1+ years of managed care pharmacy experience required
Clinical pharmacy experience in a managed healthcare environment preferred

Centene Pharmacy Services: 3+ years managed care pharmacy or pharmacy benefit management experience preferred

PHARM-R - Registered Pharmacist Current state with no restrictions Upon Hire required

Pay Range: $107,700.00 - $199,300.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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