Health Outcomes Pharmacist

TL;DR

Health Outcomes Pharmacist: Driving value-based reimbursement performance and clinical outcomes for primary care providers with an accent on pharmacy formulary, medication adherence, and utilization management. Focus on analyzing performance data, transforming clinical workflows, and ensuring fiscal ROI targets are met within Medicare and Medicaid programs.

Location: Hybrid (T, W, TH) for employees residing within 50 miles of the corporate office in Pennsylvania.

Company

hirify.global is a national health and wellness organization providing comprehensive health insurance and care delivery services.

What you will do

• Serve as the clinical pharmacy subject matter expert for value-based reimbursement programs.
• Provide hands-on, office-based consultative support to primary care practices to improve quality and cost scores.
• Analyze performance data and interpret reports to identify opportunities for workflow transformation.
• Collaborate with interdepartmental teams to integrate clinical care models for chronic conditions.
• Present program results and strategic plans to internal and external stakeholders.
• Manage individual caseloads and projects to ensure adherence to formulary and medical drug policies.

Requirements

• Bachelor's Degree in Pharmacy required.
• Registered Pharmacist License required.
• 3-5 years of experience in clinical pharmacy or completion of PGY-1 residency/fellowship.
• Ability to travel 50%-75% of the time to various work sites.
• Strong analytical skills and experience with Medicare or managed care environments.
• Proficiency in interpreting quality standards like HEDIS and NCQA.

Nice to have

• Doctorate Degree in Pharmacy (PharmD) or Master's in Health Administration/Business.
• Board certification in Pharmacotherapy, Ambulatory Care, or Geriatric Pharmacy.
• 5-7 years of experience in Medicare or managed care support.

Culture & Benefits

• Hybrid work model promoting flexibility and office-based collaboration.
• Opportunity to work in a matrix management environment with cross-functional teams.
• Focus on continuous improvement and professional development in value-based care.
• Commitment to ethical standards and compliance with federal and state healthcare regulations.