Location:Johns Hopkins Health Care, Hanover, MD 21076
Who you are:
As a Medicare Pharmacy Operations Specialist, you are a Pharmacy Tech who can identify gaps in processes and think critically to analyze performance and identify opportunities for improvement. You have a good understanding of Pharmacy Benefit Manager (PBM) basic structure and processing systems. You are super analytical and like the challenge of reviewing reports. You understand your impact on member experience and furthering our quality initiatives, and use your experience to drive operational change.
What you'll do:
What you'll bring:
- Implement, track and support new and existing healthcare quality improvement initiatives and education programs by contributing to these quality improvement functions:
- Tracks and supports new and existing healthcare quality improvement initiative projects and member level gaps
- Monitors and ensures that key STARS activities are completed on time and accurately to present results to key departmental management
- Understands pharmacy related quality reports and identify areas for intervention and improvement (e.g. medication claim reversals, grievances, etc.)
- Conducts outbound communications to beneficiaries/providers regarding open quality measures
- Collaborate with internal and external stakeholders/vendors on pharmacy outreach initiatives to help achieve quality program targets with the goal to optimize medication use, maximize member and pharmacy experience, and Star measure outcomes.
- Assist with daily oversight of the Pharmacy Benefit Manager (PBM) activities
Who we are:
- 2+ years' experience as a Pharmacy Tech required.
- Understanding of STARS and PBM Operations preferred.
- Proficiency in Microsoft Office Suite, specifically Excel.
- High school diploma or equivalent
Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine. JHHC is a $2.5B business serving over 450,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC is a leader in provider-sponsored health plans and is poised for future growth.
Many organizations talk about transforming the future of healthcare, at Johns Hopkins HealthCare, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHC is the place to call home.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law. Apply To apply, visit https://jobs.hopkinsmedicine.org/job/medicare-part-d-ops-specialist-non-clinical-professional-johns-hopkins-health-care-616840-1cb31/
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