Clinical Pharmacist: Star/HEDIS Outreach & 5-Star MTM
$42.26 - $45.78 per hourJobRx, Inc.
We are looking for a Clinical Pharmacist to join our growing team. You will be offered a competitive hourly rate of $42.26-$45.78/ hour. We will also provide you a comprehensive benefits package. As a Clinical Pharmacist you will be highly focused on telephonic outreach, with our pharmacists spending much of their time reaching out proactively to members, providers, and pharmacies to help close medication adherence gaps. This position serves as internal and outward-facing, dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and expectations, and developing and managing initiatives to achieve 5 stars. The position has oversight responsibilities driven by metrics to manage vendors, retail pharmacy , prime, Magellan and health systems to deliver outcomes as outlined in different programs as well as reporting to internal stake holders Responsibilities of the Clinical Pharmacist: Clinical pharmacist will be responsible for managing outreach efforts and pull-through for Star/HEDIS clinical programs. Coordinate between the pharmacy department, health systems, and Magellan Clinical pharmacist will be responsible for driving results to obtain 5-Stars for Medicare Part D Star clinical programs including Adherence (DM, RAS, Statins), SUPD, and CMRs for MTM Oversee the daily clinical activities related to Star/HEDIS measure goals for various health systems. Ensure clinical goals and objectives are met Identify problems related to Star/HEDIS measures that require a clinical solution, implement and monitor clinical pharmacy solutions in support of Horizon's Star/HEDIS goals to save money and improve care. Major responsibility is to serve as clinical liaison between pharmacy department and health systems, assisting with managing overall relationship and driving adoption of recommended clinical solutions Develop, review and monitor clinical programs, therapeutic initiatives, pathways of care and other drug use policies and practices in support of Star/HEDIS initiatives. Works closely with the pharmacy department managers, vendors, and health systems to ensure execution of programs Maintain continuity among health systems by communicating and documenting program design and execution in accordance with pharmacy department expectations Track, analyze and report on patient interventions, interactions and findings of disease management activities. With support of the data team, develop and track the appropriate metrics to monitor the quality, care, and cost impact of the Star/HEDIS program and monitor overall healthcare trends within the Medicare populations Conduct member, provider, and pharmacy outreach/interventions and Comprehensive Medication Reviews as needed to achieve Stars goals The position requires communication across all departments; an understanding of the strategic impact of the programs; and extensive knowledge of how the Star/HEDIS programs integrate with other clinical initiatives Understand the financial impact of all clinical recommendations: Programs must address the impact on customers, operations, program integrity, pricing, quality and satisfaction #J-18808-Ljbffr
- ...Healthforce, LLC is looking for a Remote Clinical Pharmacist to support health care clients in New... .... This contract position requires 2-5 years of experience in pharmacy and... ...responsibilities including managing outreach for Star/HEDIS initiatives and overseeing clinical...HEDISOutreachWeekly payContract workRemote work
- ...Title: Clinical Pharmacist (Star/HEDIS Programs) Location: Newark, NJ (Hybrid) Duration... ...initiatives aimed at achieving 5-Star outcomes for Medicare... ..., Statins), SUPD, and MTM/CMR completion. Coordinate with... ...provider, member, and pharmacy outreach, including Comprehensive...HEDISOutreach
- ...in Newark, New Jersey is seeking a Clinical Resource responsible for managing Star/HEDIS initiatives within the pharmacy... ...pharmacy department, focus on achieving 5-star quality ratings for Medicare... ...of relevant experience. A current pharmacist license in New Jersey is required....HEDIS
$42.26 - $45.78 per hour
...Clinical Pharmacist We are looking for a Clinical Pharmacist... ...focused on telephonic outreach, with our pharmacists... ...department in identifying Star/HEDIS measure needs and... ...initiatives to achieve 5 stars. The position has... ...), SUPD, and CMRs for MTM Oversee the daily clinical...HEDISOutreachHourly pay- ...Job Title: Clinical Pharmacist Job Location: Newark, NJ (Remote... ...) Shift: 8 to 5 standard working... ...responsible for supporting Star/HEDIS quality measures and... ...Responsibilities: Manage outreach efforts and drive... ...RAS, Statins), SUPD, MTM, and CMR initiatives...HEDISOutreachWork at officeRemote workShift work
- ...Senior Healthcare Analytics Developer (HEDIS & Stars) Location: Remote/WFH We are seeking a highly technical Healthcare Analytics Developer... ...of measure logic changes. Required Qualifications • 5+ years of healthcare analytics, business intelligence, or healthcare...HEDISRemote workWork from home
$51.75 per hour
...Outcomes is looking for a Medication Therapy Management (MTM) Clinical Program Pharmacist to provide patient-centered services for optimizing medication... ...includes delivering MTM services, conducting patient outreach, and collaborating with healthcare teams. Ideal...OutreachHourly payRemote work- ...Operating Inc is seeking a Medication Therapy Management (MTM) Clinical Program Pharmacist in the United States. This role involves optimizing... ...conducting comprehensive medication reviews, proactive patient outreach, and collaboration with healthcare teams. A Bachelor's...OutreachRemote workFlexible hours
$300 per month
...Opportunity We are seeking a Clinical Pharmacist to be a key contributor across... ...of eligible patients by outreaching, enrolling, and engaging patients... ...Medication Therapy Management (MTM), and Comprehensive... ...to 4% of your annual salary 5 sick days and unlimited (or...Outreach$51.75 per hour
...JOB SUMMARY The Medication Therapy Management (MTM) Clinical Program Pharmacist will provide patient-centered MTM services for the purpose of optimizing... ..., and Transitions in Care. Conduct proactive patient outreach to introduce and explain MTM program benefits, overcoming...OutreachHourly payWork experience placementReliefWork at officeRemote work$152k - $190k
## Clinical Pharmacy ManagerApplylocations: 111 East... ...Scheduled Hours:**8:30 AM-5 PM**Scheduled Daily... ...aligned with CMS Star Ratings, HEDIS measures, and value-based... ...optimization, AI-enabled outreach, RPM workflows), and... ...required.* ## Valid NYS Pharmacist license and...HEDISOutreachRemote workShift work- ...New York, NY 10004 Shift: 9 AM - 5 PM (Hybrid) Duration: 3 Months... ...Manager in enhancing Medicare Star Ratings and CAHPS results... ...member, pharmacy and provider outreach to coordinate care and address... ...required. Knowledge of CMS Stars, HEDIS, CAHPS, Drug Adherence and Member...HEDISOutreachContract workShift work
$102.55k - $115.37k
...Monday - Friday, 9:00am - 5:00pm Compensation: $102... ...between Risk Adjustment and the HEDIS/Quality abstraction team,... ...redundant provider outreach and maximizing the clinical value of each chart interaction... ...Factor (RAF) performance, and STARs quality measure outcomes,...HEDISOutreachFull timeWork experience placementRemote workMonday to Friday$39.96k - $70.2k
...provider and member outreach to reconcile member records... ...and Information Set (HEDIS) rates and STAR measures for the... ...outreach supporting the MTM, OMW, and Medication... ...receipt of important clinical services to improve... ...secure appointments with pharmacists and/or vendors to...HEDISOutreach$71.7k - $103.73k
...key contributor to the Medicare Advantage STAR Program, responsible for analyzing... ...operational support to drive improvements in clinical quality, customer experience, pharmacy measures... ...changes related to STAR Ratings, HEDIS, CAHPS, and Medicare Advantage. You Will...HEDISFor contractorsRemote work$55 - $63 per hour
...CMM) service augmented by an extended clinical pharmacy team. We help patients... ...and dedicated Ambulatory Care Clinical Pharmacist fluent in Spanish (healthcare‑speaking... ...do Close clinical gaps to improve CMS Star ratings and HEDIS measures. Conduct comprehensive medication...HEDISHourly payReliefRemote workWork from home- ...youth activity across the board. THE HISTORY: Super Soccer Stars has been in the youth soccer business for over 22 years and... ...maximum revenue from existing partnerships Manage community outreach by developing and maintaining relationships with local businesses...OutreachTemporary workWork at officeLocal area
- ...care through direct provider and member outreach, collaboration with provider engagement,... ...guidelines or otherwise supported by the clinical compendia Provide clinical pharmacy... ...accredited school of pharmacy Registered Pharmacist, with a state license in good standing...OutreachWork experience placementLocal area
- ...understanding of Quality Process, Performance and HEDIS measures ~ Working within comprehensive... ...performing below services under Medicare STARS Initiative: Reconciling daily,... ...reference-guidance, Call Center notes, multiple databases, and telephone outreach....HEDISOutreachContract work
- ...care teams to enhance operations, automate compliance, and provide tailored outreach, resulting in improved patient outcomes. Clinics benefit from improved screening adherence, superior STAR/HEDIS performance, reduced staff workload, and increased revenue, all while...HEDISOutreachPart timeRemote work
- ..., GAD-7, utilization patterns) to guide clinical decisions and track patient progress.Identify... ...-risk populations through proactive outreach and care interventions.Perform risk... ...Familiarity with quality measures such as HEDIS, STAR ratings, and other performance-based metrics...HEDISOutreachNight shiftWeekend workAfternoon shift
$40.2k - $54.57k
...students with a structured, clinically oriented learning experience... ...while supporting evidence-based outreach, care coordination, and... ...support program goals (e.g., Stars/HEDIS‑aligned initiatives where applicable... ...New York, which includes the 5 boroughs, Long Island,...HEDISOutreachTemporary workWork experience placementInternshipSummer internshipWork at officeLocal areaImmediate startWork from home$85k - $110k
...Care Manager (RNCM) will be the founding clinical hire for our Medicare care management... ...operations to define caseload models, outreach triggers, and performance metrics Identify... ...ACO quality and utilization goals (HEDIS, STARs, TCM, etc.) Document care management...HEDISOutreach- ...Overview The Transitional Care Clinical Pharmacy Manager is a core... ...aligned with CMS Star Ratings, HEDIS measures, and value‑based care... ...telehealth optimization, AI‑enabled outreach, RPM workflows), and... ...experience are required. Valid NYS Pharmacist license and registration...HEDISOutreachRemote work
- ...driven initiatives aligned with HEDIS (Healthcare Effectiveness Data... ...measures. This role involves clinical data abstraction, patient... ...abstraction findings. 2. Patient Outreach & Education a. Conduct... ...barriers. b. Help improve STAR ratings by ensuring adherence...HEDISOutreachInternshipWork at office
- ...This position will work towards meeting clinical, financial and operational performance goals... ...document member and provider outreach and engagement activities to support complex... ...Providers and the healthcare teams with HEDIS/STARS measures. Ensure members receive services...HEDISOutreachWork experience placementLocal areaFlexible hours
$114k - $143k
...RN Clinical Care Manager/Case Manager - New York Position Summary: The RN Clinical Care... ...Kidney Health Management interventions and HEDIS/STAR measures for identified areas of... ...benefit from Care Navigation support, conduct outreach, and engage members in program Educate Healthmap...HEDISOutreachTemporary workWork at officeLocal area- ...their Quality Management department. The role involves supporting the development of monitoring structures for data reports related to HEDIS-QARR projects and Medicare performance improvements. Candidates should have 4-6 years of experience in an analytical role, expertise...HEDIS
- ...The POD Pharmacist helps develop and implement Monogram’s medication therapy management (MTM) program which will ensure appropriate use of... ...communicate them to Monogram clinical staff and treating... ...development, targeted clinical outreach programs and quality assurance...OutreachFull timeWork at officeLocal areaRemote workFlexible hours
- ...Staffing is seeking an experienced Quality Outreach RN for a fully remote contract opportunity.... ...involves conducting member outreach to support HEDIS gap closure and improve quality performance. Ideal candidates should have 3-5 years of experience in managed care or...HEDISOutreachRemote jobContract work
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