Lumeris

Clinical Pharmacy Director, Part D Stars

Lumeris

full-time

Posted on:

Location: 🇺🇸 United States

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Job Level

Lead

About the role

  • Serve as a Part D Stars subject matter expert - provide clinical guidance and recommendations to enhance member outcomes, medication adherence, and overall health plan performance related to Part D Star measures
  • Develop, recommend and implement Part D Stars operational strategy and roadmap
  • Analyze, interpret, and enhance Part D Stars data and other pharmacy utilization reporting to identify areas for improvement and develop action plans to drive performance improvement
  • Develop provider focused education and best practice content to be used in external partner meetings that drive improvement in Part D Stars and pharmacotherapy utilization optimization which supports safe and effective medication use
  • Collaborate with cross-functional teams, including but not limited to provider services, quality, data analytics, pharmacy operations to ensure alignment and execution of Part D Star improvement initiatives
  • Participate in oversight of Part D Stars vendors and identify new partnership opportunities
  • Clearly articulate progress, achievements, and opportunities related to Part D Star measures to key stakeholders
  • Assists in the development and review of pharmacy utilization reports targeted at physician group level and physician-specific level. Makes recommendations on ways to optimize pharmacotherapy utilization
  • Trains pharmacy team members and other internal stake holders on Part D Star measures, initiatives, best practices and how to leverage target reporting to engage provider group partners.
  • Guides and mentors team members to achieve departmental and company goals
  • Collaborate closely with the VP, Clinical Pharmacy and Director, Pharmacy Operations to oversee and execute all pharmacy operations pertinent to Part D Stars and pharmacy benefit optimization
  • Stay abreast of industry trends, regulatory changes, and best practices related to Part D Star measures and quality improvement
  • Performs special projects as assigned

Requirements

  • Doctor of Pharmacy (PharmD) with a valid, registered pharmacy license in good standing
  • Five (5) or more years of Managed Care experience or relevant clinical experience or the knowledge, skills, and abilities to succeed in the role
  • Three (3) or more years of Medicare Advantage HEDIS/Stars experience
  • Board certification in one or more of these areas of focus: Board Certified Pharmacotherapy Specialist (BCPS), Board Certified Ambulatory Care Pharmacist (BCACP) and/or Board-Certified Geriatric Pharmacist (BCGP)
  • Experienced in leading projects that consistently achieve desired results with the ability to organize, prioritize, multi-task, and delegate tasks effectively
  • Demonstrated ability to communicate effectively with diverse stakeholders and collaborate cross functionally
  • Proactively identifies opportunities for improvement and takes ownership of solutions
  • Adept at tailoring complex medication information from various sources (ie: prescription, OTC, herbal) to patients and other healthcare professionals in a clear, concise, and accessible manner
  • Coached and mentored team members to enhance their skills and performance
  • Creative thinker with strong judgment and motivation to problem solve
  • Self-starter, possessing willingness and ambition to work through ambiguity
  • Experienced in managing, analyzing and interpreting data sets with the ability to articulate actionable recommendations based on findings
  • Strong computer skills including Microsoft Office
  • Gifted public speaker and polished presentation style
  • Preferred Clinical experience in ambulatory care
  • Completion of an ASHP Accredited PGY-1 Pharmacy Residency
  • Experience using Electronic Medical Records (EMR), such as EPIC or AllScripts
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