Manager, Pharmacy Stars and Member Outreach
Capital Blue Cross
full-time
Posted on:
Location Type: Remote
Location: Pennsylvania • United States
Visit company websiteExplore more
Salary
💰 $83,800 - $157,890 per year
About the role
- Responsible for day-to-day coordination, leadership, and strategy of the Pharmacy Member Outreach arm of the Medicare Pharmacy team
- Oversee the PBM Care Team performance
- Prioritize daily, weekly, monthly focus of PBM Care Teams and Member Outreach team
- Clear oversight and formal assessment of PBM Care Team performance
- Manage personnel issues, including hiring, training, staff performance reviews, and facilitating staff development activities.
Requirements
- 5 years of experience working with Medicare Advantage Plans, or managed care industry
- 1 year of leadership experience, particularly in the health insurance or pharmacy benefit manager field
- Strong knowledge and experience working with CMS Stars Ratings measures including HEDIS, CAHPS, PQA/Pharmacy, HOS, Operations, and CMS Display measures
- Analytical skills which can translate into practical and pragmatic recommendations
- Bachelor's Degree in Public Health, Health-related Sciences, or Health Administration; Business Administration, Data Analytics, Data Science, Finance, Actuarial, Mathematics or Statistics or 4 years of relevant experience in lieu of degree.
- Preference will be given to candidate with relevant pharmacy related training, certification, or degree.
Benefits
- Medical, Dental & Vision coverage
- Retirement Plan
- Generous time off including Paid Time Off, Holidays, and Volunteer time off
- An Incentive Plan
- Tuition Reimbursement
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
CMS Stars RatingsHEDISCAHPSPQAHOSOperationsData AnalyticsData ScienceFinanceMathematics
Soft Skills
leadershipanalytical skillsstaff developmentperformance assessmentcoordinationstrategy
Certifications
Bachelor's Degree in Public HealthBachelor's Degree in Health-related SciencesBachelor's Degree in Health AdministrationBachelor's Degree in Business AdministrationBachelor's Degree in Data AnalyticsBachelor's Degree in Data ScienceBachelor's Degree in FinanceBachelor's Degree in ActuarialBachelor's Degree in MathematicsBachelor's Degree in Statistics