Make outreach calls to members to address care gap issues.
Identify root causes for medication adherence issues and provide education to help resolve the problems.
Help members be set up for mail order prescriptions and handle follow-up mailings.
Confirm members’ current medications and identify discrepancies.
Provide administrative support for Performance Programs and other pertinent departments for collaboration on Star, HEDIS and P4P initiatives.
Maintain the internal tracker with dates and activities summarized and provide regular reporting on patients who are /are not at target goals based on CMS Star metrics.
Communicate with physician offices to clarify prescription orders, follow up on pharmacist recommendations on medications or fax communications.
Be proficient in Excel with ability to sort and filter cases based on priority.
Maintain reference documents related to the assigned role.
Follow up with appropriate personnel (both internally and externally) when problem arises.
Conduct ad-hoc projects, batch mailings/ faxing and follow-up to close gaps.
Create reports to track progress and intervention outcomes.
Participate in pharmacy orientation programs, pharmacy staff meetings, in-service educational programs and other functions as required by the pharmacy department. Complete required training, as assigned, within the established timeframes. Maintains regular attendance according to established policies.
Perform other job-related duties as assigned.

High School Diploma or GED
Working knowledge of MS Word, Excel
Excellent verbal and written communication skills
Strong organization skills and ability to prioritize daily tasks.
Ability to maintain member confidentiality and protect operations by keeping confidential information in compliance with HIPAA requirements.

The national target pay range for this role is $45,000
$58,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
This is a remote position. The home office is located at 600 City Parkway West 10th Floor, Orange, CA 92868.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Pharmacy Quality Coordinator

Key skills