Pharmacy Government Stars Specialist

Job Description :

The Pharmacy Government Stars Specialist is responsible for supporting and improving the quality performance of Government programs, particularly Medicare, with a strong focus on clinical measures and patient outcomes. This role plays a key part in CMS Stars initiatives, including but not limited to medication adherence, MTM (Medication Therapy Management), SUPD (Statin Use in Persons with Diabetes), and other targeted projects aimed at improving CMS Star Ratings.

The incumbent serves as a liaison between members, providers, pharmacies, and internal teams, delivering superior customer service aligned with company values, policies, and quality standards. Responsibilities include ensuring consistent medication fills and appropriate usage, coordinating prescription refills with physicians, and working with pharmacies to prevent delays in medication access.

The specialist is also tasked with identifying and engaging members in programs that enhance adherence and overall health outcomes, building strong relationships that foster long-term improvements in quality metrics.

All work must comply with established standards for response and handling times, call flow, auditing criteria, and confidentiality protocols to ensure member information remains protected in accordance with internal policy and applicable regulations.

Schedule

M-F 8am to 5pm MST

This is remote with option to work in person. If working remote, must have reliable, high speed internet, along with a contingency plan in case of service disruptions

We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states : California, Connecticut, Hawaii, Illinois, New York, Rhode Island, Vermont, and Washington.

Job Essentials

Meets all team standards related to call statistics, production, documentation, quality, and accuracy.

Demonstrates the ability to multi-task, troubleshoot problems, and adapt in a fast-paced environment.

Utilizes motivational interviewing techniques to engage members and support behavior change.

Collaborates with members to improve medication adherence and overall health outcomes.

Builds strong relationships through effective communication and interpersonal skills.

Continuously seeks opportunities to improve processes and systems in pursuit of excellence.

Acts as a mentor by coaching and developing others, offering constructive and actionable feedback.

Represents the team in government meetings or special projects as assigned by a supervisor.

Supports additional responsibilities as needed, including data analytics and general reporting.

Maintains the confidentiality of members' personal information in compliance with internal confidentiality policies.

Accurately documents customer history using appropriate codes and detailed comments in member tracking systems.

Minimum Qualifications

Demonstrated experience in a pharmacy or government role.

Understanding of Medicare Part D Stars Program.

Demonstrated ability to provide superior customer service.

Demonstrated ability to listen and communicate effectively.

Demonstrated ability to solve problems and work under pressure.

Demonstrated proficiency in Microsoft Excel

Demonstrated proficiency in navigating computer systems, typing, and technologies.

Preferred Qualifications

• Current National Pharmacy Technician certification.

Skills

Pharmacy

Pharmacy Benefits Management (PBM)

Medical Prescriptions

Pharmacy Claims

Call Center

Customer Service

Problem Resolution

Phone Calls (Inbound / Outbound)

Oral Communication

Written Communication

Group Problem Solving

Medicare Part D

Medicaid

Mentorship / Coaching

Decision Making

Microsoft Excel

Physical Requirements

Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.

Frequent interactions with providers, colleagues, customers, patients / clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.

Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.

Physical Requirements :

Location :

SelectHealth - Murray

Work City : Murray

Work State : Utah

Scheduled Weekly Hours :

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$26.93 - $40.98

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here () .

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.