Pharmacy Programs Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop, oversee, and respond to cases while escalating to Clinical Pharmacists as necessary.

• Assist with Medicare Part D Star measures by addressing medication management issues and offering recommendations based on patient interviews or profile assessments.

• Act as a representative of the Pharmacy team in cross-departmental meetings.

• Gather and present data and trends related to PBM delegated functions to suggest process enhancements.

• Implement cross-functional projects and deliver ad-hoc initiatives.

• Offer expertise on clinical and regulatory pharmacy workflows, policies, and procedures.

• Serve as a liaison between the PBM Account Management Team and Clover Health, escalating issues for resolution as needed.

• Coordinate pharmacy team meetings with both internal and external stakeholders.

• Delegate tasks and strategize the completion of quality assurance projects.

• Keep the internal knowledge base updated with Part D content.

• Lead educational sessions on Part D knowledge and vendor platforms.

• Participate in quality assurance evaluations for the call center.

• Conduct strategic initiatives to enhance MTMP Star measures.

• Utilize tools and platforms for task and queue management.

• Act as a resource for colleagues and undertake program or project-based work.

• Report issues to pharmacy leadership.

• File, examine, and verify reports to ensure Medicare compliance.

• Collect data and create reports to enhance clinical pharmacy quality metrics.

• Engage in the training and onboarding of new team members.

• Perform other assigned tasks as required.

⛳️ Requirements

• National Certification (CPhT) Pharmacy Technician License (preferred).

• Minimum of three (3) years of experience in pharmacy, managed care organizations, medical offices, or hospital settings.

• Proficiency in both English and Spanish, spoken and written.

• Familiarity with managed care principles.

• Proficient in PC applications in Windows environments.

• Strong written and verbal communication skills.

• Availability to work Eastern Time (ET) hours; candidates located in this time zone are preferred.

🏝️ Benefits

• Competitive base salary.

• Equity opportunities available.

• Performance-based bonus program.

• 401(k) matching contributions.

• Regular reviews of compensation.

• Comprehensive medical coverage.

• Dental insurance provided.

• Vision insurance available.

• No-Meeting Fridays.

• Monthly company holidays.

• Access to mental health resources.

• Generous flexible time-off policy.

• Remote-first work culture.

• Opportunities for learning programs.

• Mentorship available.

• Funding for professional development.

• Regular performance feedback and reviews.

• Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities.

• Reimbursement for office setup costs.

• Monthly stipend for cell phone and internet expenses.

• Collaboration opportunities with global teams.

• Paid parental leave for all new parents.