Clinical Pharmacist III - Quality and ACO

Medica; Minnetonka (MN); On-site; USD 98,000 - 169,000; Full time

Job summary

An established industry player is seeking a Clinical Pharmacist to enhance pharmacy-related initiatives and improve clinical outcomes. This role involves collaborating with internal and external stakeholders to optimize utilization management and drive quality improvement initiatives. The ideal candidate will possess a strong understanding of Medicare STARs measures and the health plan space, leveraging data-driven insights to identify market trends and develop actionable recommendations. Join a forward-thinking organization committed to diversity, equity, and inclusion, where your contributions will significantly impact the quality of care provided to members and the community.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401K Contributions

Paid Volunteer Time Off

Generous PTO

Holidays

Caregiver Services

Qualifications

• 5+ years of experience in pharmacy-related roles required.
• Strong understanding of Medicare STARs measures and health plan space.

Responsibilities

• Support pharmacy-related initiatives to drive quality improvement.
• Collaborate with stakeholders to optimize clinical programs.

Skills

Interpersonal Skills

Data Analysis

Public Speaking

Creative Thinking

Problem Solving

Organizational Skills

Customer Focus

Education

Bachelor's degree in Pharmacy

PharmD

Job description

The Clinical Pharmacist will support pharmacy-related initiatives that drive quality improvement and Accountable Care Organization (ACO) clinical outcomes. In this role, you will collaborate with both internal and external stakeholders to optimize utilization management, clinical programs, and quality initiatives. The ideal candidate will use industry knowledge and data-driven insights to identify market trends and develop actionable recommendations that support Medica’s goals.

Areas of focus include partnering with Accountable Care Organizations to drive clinical initiatives, review and analysis of pharmacy data, and operationalizing quality improvement initiatives. This role requires a balance of clinical expertise, strategic thinking, and strong interpersonal skills.

Key Accountabilities

• Acts as the pharmacy subject matter expert during quarterly business reviews and meetings with Accountable Care Organizations (ACOs).
• Contributes to the development and execution of Medicare STARs clinical programs to improve performance.
• Participates actively in both internal and external clinical pharmacy meetings to support and enhance key initiatives.
• Educates and promotes targeted performance improvement opportunities across the enterprise.
• Partners with internal clinical pharmacy team and Analytics to analyze pharmacy trends to develop negative trend mitigation strategies.
• Understands and promotes clinical pharmacy program strategies such as biosimilar utilization optimization.

Strategic goals are focused on enhancing pharmacy-related STARs initiatives and collaborative development of success metrics to evaluate the performance of each program and initiative. The individual in this role will ensure that such work is done in compliance with applicable state and federal regulations.

It's important that our Clinical Pharmacist has a strong understanding of Medicare STARs measures, the health plan space, PBM business practices, and vendor management. This position will need to effectively navigate a large health care organization and understand the unique needs of customers including members, providers, and internal peers.

Qualifications

• Bachelor’s degree in Pharmacy required; PharmD preferred.
• 5+ years of related experience.

Certifications/Licensure

• Valid, registered pharmacy license (in any state).

Skills and Abilities

• Prior experience with regulated markets from a health plan or PBM standpoint is required.
• Experience working in a matrixed or multi-disciplinary environment is preferred.
• Strong interpersonal and relationship-building skills will be key in partnering with health systems.
• Organized individual who can simultaneously balance and execute through multiple projects and priorities.
• Self-starter, possessing willingness and ambition to work through ambiguity.
• Creative thinker.
• Motivated to problem solve.
• Experience managing and analyzing data sets.
• Public speaking and polished presentation style.
• Collaborative, team-oriented spirit.
• Excellent written and verbal communication skills.
• Customer/patient focused.
• Operates with flexibility in changing business environment.
• Proven track record on consistently achieving desired results.

This position is a hub-based role which requires onsite presence. To be eligible for consideration, candidates must reside within a commuting distance to one of the following office locations: Madison, WI, Minnetonka, MN, or Omaha, NE. Onsite frequency is determined by business need as decided by leadership and may be up to 2-3 days a week.

The full salary range for this position is $98,400 - $168,600. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.