Health Outcomes Pharmacist - DSNP (Peak Health)

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HealthcarePharmacist

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Quick Summary

Key Responsibilities

The statements described here are intended to describe the general nature of work being performed by people assigned to this position.

Requirements Summary

EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1.

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HealthcarePharmacist

About the Role

~1 min read

The Health Outcomes Pharmacist is a vital member of Peak Health’s clinical and quality operations, responsible for optimizing medication use and improving health outcomes across the member population. This position supports care management and quality initiatives by providing clinical pharmacy expertise, conducting medication reviews, addressing pharmacy benefit inquiries, and identifying and resolving medication-related issues.

Working closely with interdisciplinary care teams, providers, and internal stakeholders, the Health Outcomes Pharmacist helps ensure safe, effective, and evidence-based medication therapy, with a particular focus on members with chronic or complex conditions. The pharmacist supports regulatory and quality performance efforts, including HEDIS and Medicare Star Ratings, by promoting medication adherence, identifying gaps in care, and contributing to the evaluation of outcomes and interventions.

The ideal candidate will bring a strong foundation in clinical pharmacotherapy, knowledge of Medicare and Medicaid pharmacy benefit regulations, and experience in managed care or population health. Success in this role requires analytical skills, attention to detail, and the ability to collaborate across departments to meet organizational goals related to quality, cost, and member experience.

Requirements

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1. Must possess current license as required by state board where services will be provided:
PA: Pharmacist license through the Pennsylvania State Board of Pharmacy
MD: Pharmacist license through the Maryland Board of Pharmacy
OH: Pharmacist license through the Ohio Board of Pharmacy
WV: Pharmacist license through the West Virginia State Board of Pharmacy
Remote Workers only: Must additionally hold current Pharmacist license issued by state of residence.

1. Three (3) years experience working in a managed care, health plan, or population health environment.

2. Three (3) years proven experience with quality measurement programs including HEDIS, Stars Ratings, and Medicare Advantage and Medicaid regulations.

3. Three (3) years in clinical pharmacy practice.

1. Managed Care Residency, Ambulatory Care Residency, OR Board Certification in Pharmacy specialties such as Board Certified Pharmacotherapy Specialist (BCPS), Board Certified Ambulatory Care Pharmacist (BCACP), or Board Certified Geriatric Pharmacy (BCGP).

2. In-depth knowledge of Medicare Part D and Medicaid pharmacy benefits.

3. Experience collaborating with interdisciplinary care teams, case managers, and providers to optimize medication use.

4. Experience in Medication Therapy Management (MTM), proficiency in utilizing MTM platforms and tools.

5. Proficiency with electronic health records (EHR) systems, such as EPIC.

Responsibilities

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1. Ability to work under stressful working conditions.

2. Ability to handle and maintain confidential information.

3. Ability to work cooperatively as a team member with articulate oral and written communication and presentation skills.

4. Ability to work in a fast-paced and rapidly changing environment with attention to detail.

5. Ability to work proactively and independently to research and resolve complex issues.

6. Experience with regulatory and accreditation standards.

7. Ability to apply relevant laws, regulations, requirements, and policy standards.

8. Extensive working knowledge of Microsoft Office applications including Excel, Outlook, PowerPoint, Teams, electronic medical records, and MTM platforms.

OCTOBER 2026 START DATE

will be on-site rotation at Peak Health Welcome Center (Morgantown, WV) 1-2 times/month subject to change
Heavily focused on new DSNP line of business so

United States of America (Exempt)

2405 PHH Medication Management