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Giant Eagle: Managed care senior specialist

Giant Eagle

This is a Full-time position in Pittsburgh, PA posted June 29, 2020.

Experience Required: 3 to 5 years Experience Desired: APhA Immunization Training; Clinical Pharmacy Experience; APhA Diabetes Training Education Required: Other education beyond Masters Degree; Bachelors Degree; Masters Degree Certification or Licensing Required: Pharmacy Job Responsibilities Work directly with the Managed Care Team to gain insight on contract details in order to develop proper programs and initiatives to address performance measures.

Provide feedback to Managed Care Team on performance and suggest best measurements for DIR recovery per category (RASA, DIABETES,STATIN ETC) for negotiations.

Collaborate with health plans to understand their needs and with operational knowledge suggest profitable solutions for both parties to build relationships.

Develop and implement clinical pharmacy strategies and provide oversight in collaboration with the operations team to ensure all clinical programs are implemented successfully to meet or exceed goals.

Suggest budget information for clinical services revenue, immunizations, and others in conjunction with pharmacy operations.

Participate in operational meetings at different levels in conjunction with Pharmacy District Leaders at store level or district level to coach opportunities.

Reviewing and maintaining a holistic view of our current programs within store/central services to look for efficiencies and opportunities.

Remaining competent in our pharmacy systems to be able to look for potential solutions and tools to succeed in store and understand impact when adding a process.

Providing operations measurable reporting and actions to take enabling Teams at retail to be successful on obtaining profitability goals.

Direct, educate, and execute Medication Therapy Management while working with operational district leader to align clinical initiatives.

This includes but not limited to: Mirixa,, Outcomes, and Care RX platforms.

MTM session will encompass CMRs, TIPs, GAPs, and Star Rating Adherence Programs Direct, educate, and execute Immunization services while working with operational district leader to align clinical immunization initiatives.

This includes but not limited to: store goals, employer clinics, and travel vaccination programs while also implementation of new immunization guidelines as they become available per the appropriate state board of pharmacy (state specific) Perform pharmacy visits to observe clinical pharmacy practices and make recommendations for improvements to Pharmacy District Leader for performance issues and conduct appropriate follow-up.

Develop and implement programs aligned to current dispensing software and current IT vendors to maximize efficiencies to meet CMS STARS criteria so that Giant Eagle can maximize ROI during contract negotiations with payors Write annual business plan for clinical programs utilizing appropriate reporting tools, create and execute reports as needed Perform additional duties as assigned by Supervisor