Intermountain Healthcare
Pharmacy Government Stars Specialist
Intermountain Healthcare, Jefferson City, Tennessee, United States, 37760
Overview
The Pharmacy Government Stars Specialist is responsible for supporting and improving the quality performance of Government programs, particularly Medicare, with a strong focus on clinical measures and patient outcomes. This role supports CMS Stars initiatives, including medication adherence, MTM (Medication Therapy Management), SUPD (Statin Use in Persons with Diabetes), and other targeted projects aimed at improving CMS Star Ratings. The incumbent serves as a liaison between members, providers, pharmacies, and internal teams, delivering superior customer service aligned with company values, policies, and quality standards. Responsibilities include ensuring consistent medication fills and appropriate usage, coordinating prescription refills with physicians, and working with pharmacies to prevent delays in medication access. The specialist identifies and engages members in programs that enhance adherence and health outcomes, building relationships that foster long-term improvements in quality metrics. All work must comply with established standards for response and handling times, call flow, auditing criteria, and confidentiality protocols to ensure member information remains protected in accordance with internal policy and applicable regulations. Schedule
M-F 8am to 5pm MST This is remote with option to work in person. If working remote, must have reliable, high speed internet, along with a contingency plan in case of service disruptions We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, New York, Rhode Island, Vermont, and Washington. Job Essentials
Meets all team standards related to call statistics, production, documentation, quality, and accuracy. Demonstrates the ability to multi-task, troubleshoot problems, and adapt in a fast-paced environment. Utilizes motivational interviewing techniques to engage members and support behavior change. Collaborates with members to improve medication adherence and overall health outcomes. Builds strong relationships through effective communication and interpersonal skills. Continuously seeks opportunities to improve processes and systems in pursuit of excellence. Acts as a mentor by coaching and developing others, offering constructive and actionable feedback. Represents the team in government meetings or special projects as assigned by a supervisor. Supports additional responsibilities as needed, including data analytics and general reporting. Maintains the confidentiality of members' personal information in compliance with internal confidentiality policies. Accurately documents customer history using appropriate codes and detailed comments in member tracking systems. Minimum Qualifications
Demonstrated experience in a pharmacy or government role. Understanding of Medicare Part D Stars Program. Demonstrated ability to provide superior customer service. Demonstrated ability to listen and communicate effectively. Demonstrated ability to solve problems and work under pressure. Demonstrated proficiency in Microsoft Excel Demonstrated proficiency in navigating computer systems, typing, and technologies. Preferred Qualifications
Current National Pharmacy Technician certification. Skills
Pharmacy Pharmacy Benefits Management (PBM) Medical Prescriptions Pharmacy Claims Call Center Customer Service Problem Resolution Phone Calls (Inbound/Outbound) Oral Communication Written Communication Group Problem Solving Medicare Part D Medicaid Mentorship/Coaching Decision Making Microsoft Excel Physical Requirements
Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs. Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc. Physical Requirements: Location: SelectHealth - Murray Work City: Murray Work State: Utah Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $26.93 - $40.98 Benefits & Equal Opportunity
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here. We do not include external links in the formatted description. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.
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The Pharmacy Government Stars Specialist is responsible for supporting and improving the quality performance of Government programs, particularly Medicare, with a strong focus on clinical measures and patient outcomes. This role supports CMS Stars initiatives, including medication adherence, MTM (Medication Therapy Management), SUPD (Statin Use in Persons with Diabetes), and other targeted projects aimed at improving CMS Star Ratings. The incumbent serves as a liaison between members, providers, pharmacies, and internal teams, delivering superior customer service aligned with company values, policies, and quality standards. Responsibilities include ensuring consistent medication fills and appropriate usage, coordinating prescription refills with physicians, and working with pharmacies to prevent delays in medication access. The specialist identifies and engages members in programs that enhance adherence and health outcomes, building relationships that foster long-term improvements in quality metrics. All work must comply with established standards for response and handling times, call flow, auditing criteria, and confidentiality protocols to ensure member information remains protected in accordance with internal policy and applicable regulations. Schedule
M-F 8am to 5pm MST This is remote with option to work in person. If working remote, must have reliable, high speed internet, along with a contingency plan in case of service disruptions We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, New York, Rhode Island, Vermont, and Washington. Job Essentials
Meets all team standards related to call statistics, production, documentation, quality, and accuracy. Demonstrates the ability to multi-task, troubleshoot problems, and adapt in a fast-paced environment. Utilizes motivational interviewing techniques to engage members and support behavior change. Collaborates with members to improve medication adherence and overall health outcomes. Builds strong relationships through effective communication and interpersonal skills. Continuously seeks opportunities to improve processes and systems in pursuit of excellence. Acts as a mentor by coaching and developing others, offering constructive and actionable feedback. Represents the team in government meetings or special projects as assigned by a supervisor. Supports additional responsibilities as needed, including data analytics and general reporting. Maintains the confidentiality of members' personal information in compliance with internal confidentiality policies. Accurately documents customer history using appropriate codes and detailed comments in member tracking systems. Minimum Qualifications
Demonstrated experience in a pharmacy or government role. Understanding of Medicare Part D Stars Program. Demonstrated ability to provide superior customer service. Demonstrated ability to listen and communicate effectively. Demonstrated ability to solve problems and work under pressure. Demonstrated proficiency in Microsoft Excel Demonstrated proficiency in navigating computer systems, typing, and technologies. Preferred Qualifications
Current National Pharmacy Technician certification. Skills
Pharmacy Pharmacy Benefits Management (PBM) Medical Prescriptions Pharmacy Claims Call Center Customer Service Problem Resolution Phone Calls (Inbound/Outbound) Oral Communication Written Communication Group Problem Solving Medicare Part D Medicaid Mentorship/Coaching Decision Making Microsoft Excel Physical Requirements
Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs. Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc. Physical Requirements: Location: SelectHealth - Murray Work City: Murray Work State: Utah Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $26.93 - $40.98 Benefits & Equal Opportunity
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here. We do not include external links in the formatted description. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.
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