Director Clinical Pharmacy Strategies - Medicare Star Strategy and Execution
Core
Leading a Medicare Clinical team to develop, implement, and evaluate CMS Star and CAHPS clinical interventions and cost of care management strategies for retail and medical benefit segments.
Role type
Director, Clinical Pharmacy Strategy & Operations
Builds
Medicare CMS Star performance programs and clinical intervention strategies
Domain
Health Insurance / Medicare / Clinical Pharmacy
Deliverable
dashboards & analysis
Required skills
Medicare CMS Star strategy, clinical intervention program development, cost of care management, predictive rule set management, vendor relationship management, budget management, team leadership
Preferred skills
4-Star performance achievement, root cause analysis, data-driven intervention implementation, regulatory compliance (OIG/ERISA/HIPAA), program management, cross-functional collaboration
Technologies
Excel
Responsibilities
Lead team execution of clinical intervention programs, evaluate and implement clinical quality programs, manage predictive clinical and economic rule sets, support sales and account management, collaborate with Care Management and HEDIS teams, manage budget and increase revenue, hire and evaluate direct reports
