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Clinical Pharmacist, Quality Programs

HMSA
United States, Hawaii, Honolulu
818 Ke’eaumoku Street (Show on map)
Nov 18, 2024
Evaluate, develop, implement, and maintain pharmacy quality programs. Support Medicare STARS, Medicaid and Commercial programs by developing strategies and interventions and identifying opportunities for providers to influence outcomes. Collaborates with both internal and external stakeholders for strategy development and quality program management related to clinical quality programs. Build, maintain, and measure program outcomes related to HEDIS and QRS measures. Provide subject matter expertise for medication therapy management program, medication reconciliation and medication reviews. Provides guidance to deploy action plans for pharmacies, pharmacists, physician organizations, specialists, and Federally Qualified Health Centers to boost quality scores. Create provider and member communications related to clinical quality initiatives. Support Account Management & Sales in product development and RFP responses. Evaluate/re-evaluate ongoing initiatives to assure they continue to provide value to the organization and its members. Develops and enhances utilization management strategies. Provide oversight of strategic partnership relationships and vendor management to assure contract obligations and performance metrics are on track. Provide clinical guidance for communications to the organization, members, providers and vendors on formulary changes and initiatives. Participate in the HMSA Pharmacy and Therapeutics Committee. Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid