About this role
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This hybrid role requires up to 50% travel to local providers within commuting distance of Houston, TX.
The Pharmacy Quality Performance Manager partners with health plans to drive pharmacy performance with emphasis on pharmacy quality measures. Provide expertise in enterprise pharmacy quality initiatives and serve as subject matter expert on measures across LOBs including Medicare, Medicaid, Marketplace. Cross-discipline interfacing accelerates pharmacy quality with internal teams and external provider partners.
Develop and present performance reviews in tandem with provider facing teams to address pharmacy chapter quality across members, providers, groups, H-Contract and States. Strategize and coordinate between market and enterprise initiatives for complementary efforts. Identify areas of opportunity in operations to accelerate measure performance.
Facilitate communication, understanding and training around enterprise pharmacy quality initiatives for internal provider facing teams. Extend the reach of quality performance impact through these efforts. Complies with all policies and standards while performing other duties as assigned.
Requirements
- Bachelor’s degree or advanced degree (PharmD., M.S.) in pharmacy required
- 3+ years of retail or hospital pharmacy experience or 1+ years of managed care pharmacy experience required
- Clinical pharmacy experience in a managed healthcare environment preferred
- 3+ years managed care pharmacy or pharmacy benefit management experience preferred
- PHARM-R - Registered Pharmacist in current state with no restrictions upon hire required
- Authorized to work in the U.S. without employment-based visa sponsorship
Responsibilities
- Provide expertise in enterprise pharmacy quality initiatives
- Serve as subject matter expert on pharmacy quality measures across LOBs (Medicare, Medicaid, Marketplace)
- Provide clinical and quality expertise to health plans and provider partners
- Develop and present performance reviews with provider facing teams to address pharmacy quality performance
- Strategize and coordinate between market and enterprise pharmacy measure initiatives
- Identify areas of opportunity for internal teams and external provider partners to accelerate pharmacy performance
- Facilitate communication, understanding and training around enterprise pharmacy quality initiatives
Benefits
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office schedules
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