Medicare Star & HEDIS Pharmacist - Hybrid Program Lead

Title: Clinical Pharmacist (Star/HEDIS Programs) Location: Newark, NJ (Hybrid) Duration: 3+ Months (Possible extension) Job Summary: We are seeking a Clinical Pharmacist to serve as both an internal and external clinical resource, supporting pharmacy quality initiatives focused on CMS Star Ratings and HEDIS measures. This role will drive program performance, manage cross-functional partnerships, and lead initiatives aimed at achieving 5-Star outcomes for Medicare Part D programs. Key Responsibilities: Lead and manage Star/HEDIS clinical programs, focusing on Medicare Part D measures such as medication adherence (Diabetes, RAS antagonists, Statins), SUPD, and MTM/CMR completion. Coordinate with internal pharmacy teams, health systems, and vendors (e.g., Prime, Magellan) to ensure program execution and performance. Monitor daily clinical operations tied to Star/HEDIS metrics and ensure achievement of defined goals. Identify gaps in performance and implement clinical interventions to improve quality outcomes and reduce costs. Act as a clinical liaison between the pharmacy department and external stakeholders, ensuring alignment and adoption of clinical initiatives. Develop and manage clinical programs, therapeutic guidelines, and drug utilization strategies supporting quality measures. Track, analyze, and report program performance, patient interventions, and healthcare trends within Medicare populations. Conduct provider, member, and pharmacy outreach, including Comprehensive Medication Reviews (CMRs), to improve adherence and quality scores. Collaborate with analytics teams to develop KPIs and measure program effectiveness. Evaluate financial and operational impact of clinical programs, ensuring alignment with business and quality goals. Required Qualifications: Education: PharmD or Bachelor's in Pharmacy Experience: 2-5 years in clinical pharmacy, preferably within: Health plans / Managed care Medicare / Medicaid programs Retail pharmacy with quality metrics exposure Strong knowledge of CMS Star Ratings and HEDIS measures Experience with MTM, medication adherence programs, or population health initiatives Preferred Qualifications: Experience working with vendors like Prime Therapeutics or Magellan Project management experience Exposure to healthcare analytics and reporting Licensure: Active Pharmacist license in New Jersey Key Skills: Strong communication and stakeholder management skills Ability to manage multiple projects independently Analytical mindset with experience in reporting and metrics tracking Financial and operational impact assessment Proficiency in Microsoft Excel, PowerPoint, and project management tools Regards, Abhishek Kumar Senior Recruiter View email address on click.appcast.io View phone number on click.appcast.io #J-18808-Ljbffr