Clinical Pharmacist

About the Company

Healthcare is confusing, but it doesn't need to be. A consumer-centric Medicare plan sponsor based in Boston, MA, we are a tech-focused startup that is committed to creating long-lasting partnerships with our members, our providers, and you!

About the Role

As a Clinical Pharmacist with eternalHealth you will be a core team member whose responsibilities will include supporting all activities in the Population Health Department. This position will work towards meeting financial and operational performance goals and standards. The clinical pharmacist is responsible for executing the daily activities associated with the clinical and operational components of the pharmacy benefit. This position reviews data, resolves issues, and coordinates tasks associated with pharmacy programs. This position also provides clinical support to interdisciplinary teams to improve healthcare outcomes, ensure patient safety, recommend cost-effective medication strategies, ensure compliance, and coordinate care efficiently and effectively.

We provide a unique opportunity to be a part of a health plan in its beginning stages, and you will have insight into all the operations and expertise that is required to run a successful and sustainable plan as well as build the foundation for sustainable growth that will be crucial to eternalHealth's success. Our team members are flexible and able to play different roles, while staying committed to teamwork and collaboration, and passionate about sustainable change.

Responsibilities:

• Serve as subject matter expert and provide recommendations designed to address Medicare Part D associated Stars ratings
• Identify drivers of performance and cost and develop/execute plans to address those items in an effort to raise quality scores and lower plan spend
• Assist with oversight of clinical subcontractors
• Manage and oversee pharmacy benefits processing
• Assist with collaboration efforts with eternalHealth's Third Party Administrator (TPA)
• Oversee Acumen data and report submission
• Participate in compliance and financial functions with the Medicare Compliance Officer and the Finance team
• Contribute to member and provider newsletters
• Formulary monitoring, oversight, and evaluation
• Complete comprehensive medication reviews
• Interact regularly with Population Health leadership and staff to develop and execute upon eternalHealth's overall company direction and goals, including KPIs related to cost, quality, operations, and outcomes of member care.
• Work with a high performing team of clinical and non-clinical professionals that will deliver exceptional care while meeting quality and delivery targets.
• Follow eternalHealth's strategic goals related to population health management and quality improvement, including developing and implementing analytics and project planning for quality measures.
• Provide support for marketing materials
• Comply with all guidelines established by the Centers for Medicare and Medicaid (CMS) and Massachusetts Department of Insurance (DOI), Arizona DOI, and guidelines set forth by other regulatory agencies, where applicable, and defined in eternalHealth policies.
• Other duties and responsibilities as assigned.

Requirements:

• Doctor of Pharmacy or Bachelor of Science in Pharmacy
• Master's degree in business administration or project management certification a plus
• 3 years of clinical experience
• 1+ years of Health Plan experience or Managed Care residency a plus
• Experience in program management and/or design or implementation
• Knowledge of CMS regulations
• Experience coordinating with cross-functional teams and/or external partners/stakeholders.
• Have knowledge around industry best practices and regulatory compliant reporting, preferred.
• Interpersonal skills with the ability to work in a fast-paced environment and health plan as an independent contributor with little supervision or as an active team member depending on the situation and needs.
• Strong technical skills, including with Microsoft Suite (Excel, PowerPoint, Project, etc.) and other collaborative tools.
• Ability to work on-site full-time at eternalHealth's downtown Boston office.
• Excellent written and communication skills.
• Creative, strategic, and continuously striving for improvement.
• Flexible and able to ramp-up quickly on different projects in order to support the team as needed in a fast-paced start-up environment.
• Ability to think outside the box and offer creative and compliant solutions to existing and new problems.

Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth's mission, values, and compliance standards.

Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment) please contact us separately; email HR@eternalhealth.com with the email subject "Reasonable Accommodations – Applicant Name Here".