Pharmacy Quality Coordinator

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

📋 Description

• Conduct outreach calls to members to resolve care gap issues.

• Determine the underlying causes of medication adherence challenges and offer education to address them.

• Assist members in setting up mail order prescriptions and manage follow-up mailings.

• Verify members’ current medications and identify any discrepancies.

• Provide administrative assistance for Performance Programs and collaborate with other relevant departments on Star, HEDIS, and P4P initiatives.

• Keep the internal tracker updated with summarized dates and activities, and provide regular reports on patients who are or are not meeting target goals based on CMS Star metrics.

• Communicate with physician offices to clarify prescription orders and follow up on pharmacist recommendations regarding medications or fax communications.

• Demonstrate proficiency in Excel with the capability to sort and filter cases based on priority.

• Maintain reference documents pertinent to the assigned role.

• Follow up with relevant personnel (both internally and externally) when issues arise.

• Execute ad-hoc projects, batch mailings/faxing, and follow up to close gaps.

• Generate reports to monitor progress and outcomes of interventions.

• Participate in pharmacy orientation programs, pharmacy staff meetings, in-service educational programs, and other activities as required by the pharmacy department. Complete mandatory training as assigned within the specified timeframes, and maintain regular attendance in accordance with established policies.

• Perform additional job-related duties as assigned.

⛳️ Requirements

• High School Diploma or GED.

• Proficient in MS Word and Excel.

• Exceptional verbal and written communication skills.

• Strong organizational skills and the ability to prioritize daily tasks.

• Ability to uphold member confidentiality and safeguard operations by maintaining confidential information in compliance with HIPAA regulations.

🏝️ Benefits

• The national target pay range for this position is $45,000 - $58,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

• This role is remote. The home office is located at 600 City Parkway West 10th Floor, Orange, CA 92868.

• Astrana Health is committed to being an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other legally protected characteristics. All employment decisions are based on qualifications, merit, and business needs. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

• This job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the employer's needs and job requirements evolve.