Full-Time

Remote Clinical Pharmacist

HEDIS Medication Adherence

Guidehealth

Guidehealth

51-200 employees

Optimizes healthcare provider revenue with ML

Compensation Overview

$120k - $130k/yr

Philadelphia, PA, USA

Remote

PharmD

Category
Medical, Clinical & Veterinary (1)
Required Skills
Data Analysis

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Requirements
  • Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy
  • Active pharmacist license in one or more of the following states: TX, PA, AL, TN
  • Minimum of 2 years of experience in HEDIS-related medication adherence work, quality improvement, or population health
  • Strong knowledge of HEDIS measures, particularly those related to medication adherence
  • Proficiency in using EHR systems and data analysis tools
  • Excellent communication, problem-solving, and organizational skills
  • Ability to work independently as well as in a team-oriented environment
Responsibilities
  • Lead efforts to improve HEDIS medication adherence and other pharmacy quality measures, including but not limited to adherence to antihypertensive, cholesterol-lowering, and diabetes medications
  • Analyze medication adherence data, identify gaps in care, and implement targeted interventions to improve adherence rates
  • Collaborate with healthcare providers, care managers, and other stakeholders to develop and implement strategies that promote adherence to prescribed therapies
  • Conduct medication therapy management (MTM) sessions to address barriers to adherence, provide patient education, and ensure understanding of medication regimens
  • Work directly with patients to identify and resolve issues related to medication adherence, including cost, side effects, and complex dosing schedules
  • Utilize motivational interviewing techniques to encourage patients to adhere to their prescribed medication regimens
  • Monitor and track HEDIS performance metrics, generating reports to assess the effectiveness of interventions and programs
  • Use electronic health records (EHR) and pharmacy data to identify patients at risk of non-adherence and develop action plans
  • Provide regular updates to leadership on progress towards HEDIS goals and make recommendations for improvement
  • Serve as a medication adherence SME within the organization
  • Provide training and support to other pharmacists, care managers, and clinical staff on best practices in medication adherence
  • Participate in cross-functional teams focused on quality improvement, population health management, and value-based care initiatives
Desired Qualifications
  • Experience in a managed care setting, pharmacy benefits management (PBM), or a healthcare quality improvement role
  • Certification in Medication Therapy Management (MTM), Certified Geriatric Pharmacist (CGP), or other relevant credentials
  • Understanding of value-based care models and their impact on medication adherence

Glide Health helps healthcare providers improve their finances by offering software and consulting to optimize revenue cycles. Its main product is a System of Revenue Intelligence that uses machine learning to review hundreds of millions of insurance claims. It identifies why claims are denied or underpaid and suggests actions to fix the issues, speeding up payments and lowering costs. The product is delivered as a subscription software platform plus consulting services. Glide Health differentiates itself by combining data-driven insights from large-scale claim analysis with hands-on consulting to reduce net denials by up to 60% and tackle challenges like prior authorizations, especially for specialties such as oncology and ophthalmology. The company’s goal is to help providers strengthen cash flow and financial stability so they can focus more on patient care.

Company Size

51-200

Company Stage

Early VC

Total Funding

$24M

Headquarters

Palo Alto, California

Founded

2019

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Simplify Jobs

Simplify's Take

What believers are saying

  • March 2026 Illinois behavioral health network spans 2,000+ clinicians.
  • April 2026 CMS ACCESS participation opens Medicare chronic-care revenue.
  • Emory and Firstsource partnerships expand distribution across health systems and health plans.

What critics are saying

  • Value-based care sales cycles stretch across health systems, delaying revenue conversion.
  • A CMS policy shift can erase Guidehealth's revenue base overnight.
  • Ever-larger incumbents like Optum and Epic can bundle similar care-management tools.

What makes Guidehealth unique

  • Memorial Hermann-backed and CMS ACCESS-selected in 2026 shows payer-provider credibility.
  • URAC AI accreditation August 2026 signals compliance moat in regulated healthcare AI.
  • Healthguides, Brain-Voice-Touch, and embedded workflows differentiate from pure-software rivals.

Help us improve and share your feedback! Did you find this helpful?

Benefits

Remote Work Options

Flexible Work Hours

Health Insurance

Wellness Program

Mental Health Support

Growth & Insights and Company News

Headcount

6 month growth

1%

1 year growth

1%

2 year growth

10%
Healthcare Industry Today
Jun 8th, 2026
Guidehealth founder and CEO Sanjay Doddamani, MD, named a Modern Healthcare 50 Most Influential Clinical executive.

Guidehealth founder and CEO Sanjay Doddamani, MD, named a Modern Healthcare 50 Most Influential Clinical executive. Recognition honors physician leader advancing value-based care, population health, and AI-enabled healthcare transformation DALLAS, TX, UNITED STATES, June 8, 2026 /EINPresswire.com/ - Modern Healthcare has named the Guidehealth founder and CEO to its prestigious "50 Most Influential Clinical Executives" list, honoring licensed clinicians whose leadership is helping define the future of healthcare. Over the last two decades, Doddamani has helped shape some of healthcare's most important transitions: from fee-for-service to value-based care, from episodic treatment to longitudinal population health management, and now from fragmented operations to AI-enabled healthcare delivery. A practicing cardiologist, physician executive and former senior advisor at the Center for Medicare and Medicaid Innovation (CMMI), Doddamani has spent his career working to make healthcare more accessible, affordable and sustainable. From leading value-based care initiatives at Geisinger to advising federal innovation programs - and helping to build Guidehealth into one of the nation's fastest-growing healthcare enablement organizations - he has consistently focused on improving patient outcomes while strengthening the systems that support them. Fellow honoree and former Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), and current CEO of Optum, Dr. Patrick Conway said, "Sanjay has been a physician executive leader for many years who has demonstrated innovation and impact across roles and settings in value-based care." "From the time Sanjay arrived at Geisinger, he wanted to think differently about how we care for not just individual patients but the larger population of patients," recalled former Geisinger Chief Nursing Executive Janet Tomcavage. "He challenged the norm and pushed the envelope. His approach to surrounding not only himself but the patient with a team of clinicians, advanced practitioners, RN case managers, pharmacists and community health workers, set the stage to think differently about care in the home." Today, that same philosophy drives Guidehealth, which supports nearly one million lives through technology-enabled value-based care, patient engagement, care management, and benefits administration programs. The company partners with health systems, physician organizations, clinically integrated networks, health plans, and employers to improve quality performance, strengthen care coordination, and deliver measurable clinical and financial outcomes at scale. "Dr. Sanjay Doddamani is one of the rare healthcare leaders who combines clinical credibility, operational discipline, and bold innovation to pursue his passion of making great healthcare affordable for all," said Joon S. Lee, MD, CEO of Emory Healthcare. "His work at Guidehealth is redefining how health systems and payers work to make care more accessible, more affordable, and more accountable." The recognition comes amid growing demand for clinically governed AI infrastructure and scalable approaches to longitudinal patient engagement. Under Doddamani's leadership, Guidehealth has expanded partnerships with provider organizations nationwide, earned the DiMe Seal for its RoseConnect conversational AI platform, achieved URAC accreditation in utilization management, been selected to participate in the CMS ACCESS Model, and was recently named to Forbes' list of America's Best Startup Employers for 2026. "I am grateful to my family, my colleagues and everyone I've worked with that shaped my values and my thinking over so many years," said Doddamani. "This recognition reflects our work serving patients across a variety of healthcare organizations to proactively build a more sustainable and empathic healthcare system at a time when the industry is facing enormous pressure around workforce capacity, affordability and flat health outcomes." About Guidehealth Guidehealth is dedicated to making great healthcare affordable for all. The company partners with health systems, payers, and employers to bring scale and predictable performance to value-based care and benefits administration across all lines of business. Led by physicians, Guidehealth combines advanced clinical intelligence, AI-enabled engagement, and remotely embedded Healthguides(TM) to help organizations improve quality, strengthen patient relationships, reduce costs, and achieve better outcomes. Through its Brain-Voice-Touch platform, Guidehealth delivers scalable, human-centered healthcare solutions that make care more accessible, more proactive, and more effective for the nearly one million lives it supports nationwide. Legal Disclaimer: EIN Presswire provides this news content "as is" without warranty of any kind. Healthcareindustrytoday do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.

IT桔子
Aug 14th, 2025
Guidehealth Secures $10M Strategic Investment

Guidehealth, an AI care solutions provider, has secured a $10 million strategic investment led by Memorial Hermann Health System. The funding will accelerate the company's next phase of development, focusing on transforming patient care models, advancing disease prevention, and expanding access to high-quality, value-driven healthcare services.

Moneylife
Aug 13th, 2025
Nifty, Sensex Put in an Oversold Bounce - Wednesday Market Report

Firstsource Solutions (+0.05%) partnered with Guidehealth to accelerate AI-enabled, value-based care innovation for health plans.

Modern Healthcare
Jun 10th, 2025
Emory Healthcare invests in value-based care startup

Guidehealth has developed a platform that connects health systems with AI tools to help providers engage in risk-based payment models.

HIT Consultant
Apr 22nd, 2025
Guidehealth & Koda Health Partner to Improve Advance Care Planning

- Guidehealth, an AI-powered healthcare services platform, has announced a strategic partnership with Koda Health, a platform for proactive Advance Care Planning (ACP).