Clinical Pharmacy Programs Specialist - MTM & Quality Focus

MCS Puerto Rico; San Juan (PR); Presencial; USD 60.000 - 90.000; Jornada completa

Descripción de la vacante

MCS Puerto Rico is seeking a Nurse Quality Programs Specialist to support Pharmacy Quality Clinical Programs, MTMP, COB, SUPD and SPC interventions, and medication reconciliation post discharge. This exempt, regular role focuses on telephone interventions, documentation, and collaboration with providers to improve patient outcomes.

The ideal candidate holds a Bachelor's in Nursing, at least three years in healthcare or health insurance settings, and a Puerto Rico nursing license.

Formación

• Bachelor's degree in Nursing Sciences is required.
• At least three (3) years of experience in the health care industry, or health insurance plans, physicians' offices, or hospitals.
• A valid Nurse & Association Nursing Professionals of Puerto Rico license and registration is required.

Responsabilidades

• Works on telephone interventions with beneficiaries identified for annual Comprehensive Medication Reviews (CMRs) and Targeted Medication Reviews (TMRs).
• Works on telephone interventions with beneficiaries identified for medication reconciliation addressing Diabetes management and healthy lifestyle.
• Manages interventions with recommendations for providers promoting biosimilar/interchangeable, generic medications and step therapies under the Specialty Program.
• Provides education to prescribers and beneficiaries identified in Star Measure COB for safe and appropriate treatments.
• Conducts clinical intervention calls to ensure Statin Use in Diabetes (SUPD) and Statin Therapy for Cardiovascular Disease (SPC) guidelines are followed.
• Performs medication reconciliation post-discharge for company lines of business daily.
• Channels or refers situations requested by beneficiaries/providers to ensure quality of service.

Conocimientos

Spanish language

English language

Educación

Bachelor's degree in Nursing Sciences

Descripción del empleo

MCS Puerto Rico is seeking a Nurse Quality Programs Specialist to support Pharmacy Quality Clinical Programs, MTMP, COB, SUPD and SPC interventions, and medication reconciliation post discharge. This exempt, regular role focuses on telephone interventions, documentation, and collaboration with providers to improve patient outcomes.

The ideal candidate holds a Bachelor's in Nursing, at least three years in healthcare or health insurance settings, and a Puerto Rico nursing license.