SCOPE OF ROLE

The Sr. Clinical Pharmacist - Part D Stars is responsible for ensuring end-to-end processes for Part D Stars runs effectively and efficiently for Bright Health Plan and affiliates. This pharmacist will ensure there is proper oversight and tracking of all efforts related to Stars that impact the pharmacy team. Sr. Clinical pharmacist will create new opportunities for Stars This leader will develop new strategies and drive vendors to a 4 Star goal.

ROLE RESPONSIBILITIES

• Collaborate closely with the leader of Pharmacy Operations to oversee and execute all pharmacy operations pertinent to Stars
• Analyze, interpret, and execute Part D Star data to identify areas for improvement and develop action plans to drive performance enhancement
• Collaborate with cross-functional teams, including pharmacy operations, clinical services, and data analytics, to ensure alignment and execution of Part D Star improvement initiatives
• Provide clinical guidance and recommendations to enhance member outcomes, medication adherence, and overall health plan performance related to Part D Star measures
• Develop and implementation of member, provider, and pharmacy engagement opportunities aimed at positively impacting Part D Star measures
• Participate in oversight of Part D Stars vendors and opportunities
• Communicate progress, achievements, and opportunities related to Part D Star measures to key stakeholders
• Oversee reporting from multiple part D Stars vendors and internal teams to progress network pharmacies and prescribers to support medication therapy management (MTM) initiatives, including targeted interventions to improve adherence and outcomes
• Stay abreast of industry trends, regulatory changes, and best practices related to Part D Star measures and quality improvement

SUPERVISORY RESPONSIBILITIES

• This position has responsibility for supervising the Pharmacy Operations team at Bright Health and all affiliates.
• The position will manage technician staff that oversee Medication Adherence initiatives for Brand New Day.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Doctor of Pharmacy Degree required
• Masters in Business Administration preferred
• Five (5) or more years of experience leading clinical, administrative, and medical expense functions for a health plan or stand-alone PBM required
• Experience in PBM operations, Health Plan Management and Pharma required

PROFESSIONAL COMPETENCIES

• Previous experience in Part D Stars
• Highly organized and process-driven
• Exceptional communication skills and ability to deliver Bright’s differentiated value proposition

LICENSURES AND CERTIFICATIONS

• Registered Pharmacist with a license, in good standing, to practice in any US state or territory

WORK ENVIRONMENT

• The majority of work responsibilities are performed at home or in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
• Travel may be required.