Pharmacy Stars Improvement Lead (Medicare)

Location: Remote nationwide within the United States; occasional travel to hirify.global offices for training or meetings may be required.

Salary: $104,000–$143,000 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services to Medicare, Medicaid, families, individuals, military personnel, and communities.

What you will do

• Develop, implement, and manage clinical program strategies for Pharmacy Stars performance.
• Improve Medicare members’ medication adherence and appropriate medication use.
• Design and support telehealth and in-home medication care delivery methods.
• Analyze metrics, trends, and care gaps to determine effective improvement actions.
• Exercise independent judgment on complex issues and work with minimal supervision.

Requirements

• Bachelor’s degree in business, finance, healthcare, or a related field.
• At least 2 years of project leadership experience.
• Prior Medicare or Medicaid experience.
• Strategic planning, organization, communication, presentation, and prioritization skills.
• Ability to work under tight deadlines and use Microsoft Word, Excel, and PowerPoint.
• Must be able to work remotely nationwide within the United States and maintain a dedicated workspace that protects member PHI and HIPAA information.

Nice to have

• Medication prescribing or medical coding experience as a PA, NP, or BSN.
• Master’s degree in business administration, health administration, or a related field.
• Managed care, provider relations, health solutions, or quality improvement experience.
• Knowledge of CMS Stars, performance measures, HEDIS, metrics, and care-gap analysis.

Culture & Benefits

• Collaborative Pharmacy Stars team focused on improving consumer and patient outcomes.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, holidays, parental and caregiver leave.
• Short- and long-term disability, life insurance, and wellness-focused benefits.
• Home internet requirements include at least 25 Mbps download and 10 Mbps upload speeds; approved equipment is provided as needed.

Hiring process

• Interviewing may use HireVue technology to assess relevant skills and experience.