Capital Blue Cross logo
Capital Blue Cross

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital, you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

Manager, Pharmacy Stars and Member Outreach

ManagerManagerFull TimeRemoteSeniorTeam 1,001-5,000Since 1938H1B SponsorCompany SiteLinkedIn

Location

Pennsylvania

Posted

34 days ago

Salary

$83.8K - $157.9K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

• Responsible for day-to-day coordination, leadership, and strategy of the Pharmacy Member Outreach arm of the Medicare Pharmacy team • Oversee the PBM Care Team performance • Prioritize daily, weekly, monthly focus of PBM Care Teams and Member Outreach team • Clear oversight and formal assessment of PBM Care Team performance • Manage personnel issues, including hiring, training, staff performance reviews, and facilitating staff development activities.

Job Requirements

  • 5 years of experience working with Medicare Advantage Plans, or managed care industry
  • 1 year of leadership experience, particularly in the health insurance or pharmacy benefit manager field
  • Strong knowledge and experience working with CMS Stars Ratings measures including HEDIS, CAHPS, PQA/Pharmacy, HOS, Operations, and CMS Display measures
  • Analytical skills which can translate into practical and pragmatic recommendations
  • Bachelor's Degree in Public Health, Health-related Sciences, or Health Administration; Business Administration, Data Analytics, Data Science, Finance, Actuarial, Mathematics or Statistics or 4 years of relevant experience in lieu of degree.
  • Preference will be given to candidate with relevant pharmacy related training, certification, or degree.

Benefits

  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off, Holidays, and Volunteer time off
  • An Incentive Plan
  • Tuition Reimbursement

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