Job Description:

The main responsibilities of the Clinical Quality Pharmacy Manager include: 1) managing the team assigned to quality measures; 2) managing the team for various clinical programs including interdisciplinary care team cases, high-intensity case management, key events, and ACO; 3) providing support for and leading ad hoc department /team initiatives and processes.Required Education/Experience

• Must hold an active pharmacist license.


• Experience and knowledge on star / HEDIS measures


• Prior experience with medication adherence strategies


• MTM experience is preferred


• Managed care experience is preferred

Manage the implementation and improvement of the processes targeted for quality measures (e.g., CMS star measures for medication adherence and statin, HEDIS measures related to drugs) to meet department goals through a set of monitoring reports, root-case assessments, and new initiatives. Develop and maintain policies & procedures and standard operating procedures.

Ensure the teams assigned to ICT/HICM/Key Events, and ACO cases meet department goals and metrics and address drug-related issues. Work in collaboration with other departments to implement new processes and initiatives. Monitor the performance of the teams, identify barriers and areas of improvement, troubleshoot, and monitor the programs through ad hoc reports and trackers.

Provide support for other pharmacy programs as well as company and department projects and initiatives.

Provide support for clinical committees (e.g., Pharmacy & Therapeutics, UM, QM). Develop educational materials for members and providers and coordinate with appropriate departments to ensure communication materials are approved and distributed per company policies.Manage the implementation and improvement of the processes targeted for quality measures (e.g., CMS star measures for medication adherence and statin, HEDIS measures related to drugs) to meet department goals through a set of monitoring reports, root-case assessments, and new initiatives. Develop and maintain policies & procedures and standard operating procedures.

Ensure the teams assigned to ICT/HICM/Key Events, and ACO cases meet department goals and metrics and address drug-related issues. Work in collaboration with other departments to implement new processes and initiatives. Monitor the performance of the teams, identify barriers and areas of improvement, troubleshoot, and monitor the programs through ad hoc reports and trackers.

Provide support for other pharmacy programs as well as company and department projects and initiatives.

Provide support for clinical committees (e.g., Pharmacy & Therapeutics, UM, QM). Develop educational materials for members and providers and coordinate with appropriate departments to ensure communication materials are approved and distributed per company policies.

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