Manager, Pharmacy Stars and Member Outreach
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Manager leading Pharmacy Member Outreach team and overseeing operations for Medicare Pharmacy team at Capital Blue Cross. Ensures performance standards and process improvements in pharmacy services for members.
Responsibilities:
- Responsible for day-to-day coordination, leadership, and strategy of the Pharmacy Member Outreach arm of the Medicare Pharmacy team
- Oversee the PBM Care Team performance
- Prioritize daily, weekly, monthly focus of PBM Care Teams and Member Outreach team
- Clear oversight and formal assessment of PBM Care Team performance
- Manage personnel issues, including hiring, training, staff performance reviews, and facilitating staff development activities.
Requirements:
- 5 years of experience working with Medicare Advantage Plans, or managed care industry
- 1 year of leadership experience, particularly in the health insurance or pharmacy benefit manager field
- Strong knowledge and experience working with CMS Stars Ratings measures including HEDIS, CAHPS, PQA/Pharmacy, HOS, Operations, and CMS Display measures
- Analytical skills which can translate into practical and pragmatic recommendations
- Bachelor's Degree in Public Health, Health-related Sciences, or Health Administration; Business Administration, Data Analytics, Data Science, Finance, Actuarial, Mathematics or Statistics or 4 years of relevant experience in lieu of degree.
- Preference will be given to candidate with relevant pharmacy related training, certification, or degree.
Benefits:
- Medical, Dental & Vision coverage
- Retirement Plan
- Generous time off including Paid Time Off, Holidays, and Volunteer time off
- An Incentive Plan
- Tuition Reimbursement
Similar Jobs
Quality Control Manager
Quality Control Manager ensuring quality control processes for commercial and federal construction projects at Prairie Band, LLC. Focus on documentation, compliance, and process improvement.
Web Hosting Manager
Web Hosting Manager responsible for day-to-day operations and security of AWS-hosted platforms. Collaborating with vendors and internal teams to ensure performance and compliance for CUSG's client base.
Proposals and Contracts Manager
Proposals and Contracts Manager overseeing RFP process and contract development for clinical research projects at Parexel. Collaborating across functions to deliver proposals that meet client needs.
Site Contracts and Budgets, Line Manager
Line Manager overseeing clinical site management contracting at Parexel; managing SCAs, ensuring compliance, and improving processes.
Manager, Project Planner – FSP
Manager, Project Planner managing project planning in clinical research for Parexel. Seeking skilled individuals with experience in pharmaceutical project management across Latin America.
Customer Value Manager
Customer Value Manager optimizing customer engagement and success in transportation technology. Work with enterprise clients to enhance their use of the Transporeon platform.
TikTok Shop Manager
Manage TikTok Shops and drive e-commerce growth for multiple brands as part of a leading ad agency. Collaborate on strategies, oversee teams, and optimize performance metrics.
Patient Access Manager
Manage Patient Access activities for Intermountain Health, focusing on enhancing workflows and training. Collaborate with clinical and administrative roles to optimize patient experiences and revenue cycle activities.
Branded Beef Strategic Accounts Manager – Retail/Foodservice
Strategic Account Manager for Branded Beef team at a global food company. Managing retail relationships and sales growth in the Southwest region of the USA.
Manager, MSL
Manager/MSL providing medical expertise and strategic leadership for Acute and Chronic Therapies. Engage with healthcare professionals and develop educational programs for renal replacement therapies.
Population Health Manager
Physician Practice Partner engaging with healthcare providers to enhance value-based care performance. Focused on building relationships and improving practice metrics through Honest programs and collaboration.
Credentialing Manager – ABA
Credentialing Manager leading and managing ABA credentialing operations at ReWorks Solutions. Ensuring provider compliance with insurance payers and regulatory bodies while facilitating efficient onboarding.
Case Manager – Olmstead Services
Case Manager supporting residents of Nursing Facilities for Mental Health in recovery and community reintegration, coordinating care among various providers.
Branch Manager
Mortgage Branch Manager leading loan officers and ensuring sales growth at Luminate Bank, a digital banking and lending institution.
Senior Associate / Manager, Clinical Development Trial Lead
Clinical Development Trial Lead overseeing cross-functional teams for clinical trials and ensuring quality delivery. Utilizing project management and scientific expertise to achieve trial milestones.
Service Delivery Manager
Manager of Project Management team leading delivery of Managed Services and Ethernet-based solutions for GTT. Ensuring consistent service quality and performance metrics.
Manager – Development & Sales
Manager – Development & Sales for a logistics firm providing tailored logistics solutions in France. Focus on customer acquisition and market presence.
Senior Manager, Medical Economics
Senior Manager leading data analysis and analytics projects in healthcare sector. Managing analyst teams and improving operational performance through data-driven initiatives.
Revenue Cycle Manager
Revenue Cycle Manager overseeing billing and RCM operations for a dermatology practice across 9 locations. Leading a remote team, managing performance metrics, and ensuring compliance and efficiency.
Senior Environmental, Health & Safety Manager
Senior Environmental, Health & Safety Manager overseeing EHS programs for data center operations. Ensuring compliance and safety across Serverfarm’s U.S. data centers with a focus on sustainability.