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Guidehealth

Optimizes healthcare provider revenue with ML

Clinical Pharmacist - HEDIS Medication Adherence

PharmacyConfirmed live in the last 24 hours
Full-timeRemote in USANo salary listed

About the Job

Requirements

  • A Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy is required.
  • An active pharmacist license is required, with willingness to obtain licenses in Texas, Tennessee, Alabama, and Pennsylvania; the company pays for these licenses.
  • A minimum of 2 years of experience in HEDIS-related medication adherence work, quality improvement, or population health is required.
  • Strong knowledge of HEDIS measures, particularly those related to medication adherence, is required.
  • Proficiency in electronic health record systems and data analysis tools is required.
  • Experience with motivational interviewing or other patient engagement techniques is a plus.
  • Experience in a managed care setting, pharmacy benefits management, or healthcare quality improvement is preferred.
  • Certification in Medication Therapy Management, Certified Geriatric Pharmacist, or other relevant credentials is preferred.
  • Understanding of value-based care models and their impact on medication adherence is preferred.
  • Employees must provide their own internet connection capable of video calls and use of internal and external systems, with minimum speeds of 100 Mbps download and 10 Mbps upload.
  • Employees must disclose any secondary employment and be accessible during stated working hours.

Responsibilities

  • Lead efforts to improve HEDIS medication adherence and other pharmacy quality measures, including 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 sessions to address adherence barriers, provide patient education, and ensure patients understand their medication regimens.
  • Work directly with patients to identify and resolve medication adherence issues, including cost, side effects, and complex dosing schedules.
  • Use motivational interviewing techniques to encourage patients to adhere to prescribed medication regimens.
  • Monitor and track HEDIS performance metrics and generate reports to assess the effectiveness of interventions and programs.
  • Use electronic health records and pharmacy data to identify patients at risk of non-adherence and develop action plans.
  • Provide regular progress updates to leadership on HEDIS goals and recommend improvements.
  • Serve as a medication adherence subject matter expert within the organization.
  • Provide training and support to pharmacists, care managers, and clinical staff on medication adherence best practices.
  • Participate in cross-functional teams focused on quality improvement, population health management, and value-based care initiatives.
  • Follow security policies and procedures to protect patient and company data, including protected health information and personally identifiable information.

Desired Qualifications

  • Experience with motivational interviewing or other patient engagement techniques.
  • Experience in a managed care setting, pharmacy benefits management, or healthcare quality improvement.
  • Certification in Medication Therapy Management, Certified Geriatric Pharmacist, or other relevant credentials.
  • Understanding of value-based care models and their impact on medication adherence.

About the Company

Guidehealth

Optimizes healthcare provider revenue with ML

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
Dallas, TX
Founded
2019

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