About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

The Job

Develop and execute innovative pharmacy clinical programs to improve health outcomes, enhance quality, and manage costs. Influence change by working with providers, members and cross-functionally within the organization to develop effective end-to-end clinical programs. Evaluate and analyze data and outcomes to evolve and enhance initiatives and improve results.

You Will

Create, develop, implement, and monitor clinical programs to improve Medicare 5 Star Ratings quality metrics, medication or medical issues, and cost containment. This includes, but is not limited to, creating educational materials for members and providers, managing call campaigns, and partnering with vendors.

Serve as subject matter expert for specified pharmacy quality measures. This can include, but is not limited to, staying abreast of industry trends, performing deep dive root cause analyses, strategizing, identifying opportunities, and implementing initiatives to achieve results.

Own quality measure(s) to achieve high performance. This includes, but is not limited to, developing strategy, processes, and program implementation needed to achieve desired results.

Stay abreast of CMS rules, regulations, and quality metrics to ensure requirements are met with applicable programs.

Ensure smooth and timely execution of clinical programs by facilitating meetings and follow-up on key action items.

Effectively lead the collaboration with providers (e.g., medical groups, pharmacy networks) by supporting and guiding external initiatives, and identifying and acting on new opportunities.

Effectively communicate with various healthcare professionals internally and externally for successful collaboration and implementation of initiatives.

Design studies and analyze data to measure clinical program outcomes.

Develop performance metrics to monitor and drive improvements in quality. Analyze data and identify trends to enhance initiatives and develop innovative strategies.

Develop, coordinate, and implement an effective on-going strategy to achieve appropriate drug use goals and improvement in the quality of health outcomes.

Understand utilization and quality management techniques, drug trends, and issues in Medicare to effectively develop and implement strategies to improve health outcomes while reducing cost.

Participate in interdisciplinary team meetings to discuss patient cases and perform medication reviews to improve patient health outcomes.

Serve as a pharmacy liaison that provides training, analytical and educational support and on-going performance feedback to providers and staff regarding pharmacy initiatives.

Support other clinical programs cross-functionally aimed at improving quality measures and/or compliance requirements.

Maintain professional and technical knowledge by conducting research and by attending educational and technological workshops. This position requires contributions to team effort by accomplishing and sharing related results with other staff.

Coordinate and precept pharmacy clerkship students.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your Qualifications

Pharm D. Degree Required

Current Pharmacist Licensure in California required.

Completion of residency/fellowship in Managed Care, Health Outcomes, Clinical, or Geriatric Pharmacy preferred.

Managed care experience in health plan, PBM, or medical group preferred

2 years of experience in healthcare, medical management, change management, and/or leadership.

Pharmaceutical and medical knowledge necessary to effectively discuss drug therapy issues with healthcare providers

Strong analytical, organizational, and communications skills

Strong leadership, including excellent interpersonal, problem-solving, negotiating skills, and accountability.

Ability to work cross-functionally and collaboratively across the organization

Ability to think strategically and act tactically

Self-starter, innovative, and resourceful.

Demonstrated ability to effectively multi-task to manage multiple priorities at once

Ability to work in a fast-paced ever changing work environment

Working knowledge of applicable state and federal pharmacy regulations preferred

Knowledge and/or familiarity with the principles of project and program management.

Demonstrated ability to develop and implement new, replacement systems, and gain buy-in from appropriate audience.

Able to lead and influence those without direct reporting relationships to achieve desired outcomes.

Ability to communicate with clarity, the vision, value, and tasks to formal and informal audiences.

Able to develop relationships quickly and leverage working relationships to drive performance outcomes.

Ability to work with all levels of staff, within and external to the organization to achieve goals.

Strong interpersonal skills, including excellent written and verbal communication skills.

Strong organizational skills; Ability to multitask and to appropriately maintain confidentiality.

What's in it for you?

• Base salary range: $60 to $70 per hour
• This is a temporary role with SCAN
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

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