Quality Performance Clinical Pharmacist

Centene Corporation

Job Overview

Location

Remote-NY

Job Type

Full-time

Full Job Description

📋 Description

• As a Quality Performance Clinical Pharmacist at Centene Corporation, you will play a pivotal role in improving pharmacy quality performance across Medicare, Medicaid, and Marketplace lines of business, directly impacting the health outcomes of 28 million members by ensuring safe, effective, and cost-efficient medication use.
• You will serve as a clinical and quality expert, partnering with health plans and provider organizations to drive enterprise-wide pharmacy quality initiatives, translating complex data into actionable insights that accelerate performance on key quality measures.
• Day to day, you will provide subject matter expertise on pharmacy quality measures, analyze performance trends, and identify gaps in care to recommend targeted interventions that improve adherence, reduce medication errors, and optimize formulary use.
• You will develop and deliver performance reviews in collaboration with provider-facing teams, presenting findings to health plans, provider groups, and state agencies to support quality improvement efforts across members, providers, and H-contracts.
• You will strategize and coordinate between market-level and enterprise-level pharmacy chapter initiatives, ensuring alignment and complementary efforts to avoid duplication and maximize impact on quality scores.
• You will facilitate training and communication sessions for internal teams and external provider partners, building understanding of quality programs and fostering engagement to extend the reach of quality performance improvement.
• You will collaborate cross-functionally with internal stakeholders including clinical operations, data analytics, and network management to integrate quality insights into operational workflows and provider engagement strategies.
• You will monitor regulatory changes and evolving quality measure specifications (e.g., STARs, HEDIS, CAHPS) to ensure compliance and proactively adapt strategies to maintain or improve performance.
• You will contribute to the development of best practices and toolkits for pharmacy quality improvement, sharing learnings across markets to elevate enterprise-wide capability.
• You will uphold Centene’s commitment to compliance, ethics, and equity, ensuring all activities adhere to organizational policies, regulatory standards, and fair access principles for diverse populations.
• About the team: You will join Centene’s Medical Management/Health Services team, a mission-driven group dedicated to improving healthcare quality and affordability through innovative pharmacy solutions, data-driven decision-making, and strong provider partnerships.
• Centene is a Fortune 500 healthcare enterprise serving diverse populations across the U.S., with a strong focus on underserved communities, offering you the opportunity to make a meaningful impact at scale while working in a culture that values inclusion, innovation, and continuous learning.
• In this role, you will deepen your expertise in managed care pharmacy, quality measurement methodologies, and healthcare analytics, positioning yourself as a leader in pharmacy performance improvement with opportunities to influence national quality strategy.
• You will gain experience in cross-functional leadership, stakeholder engagement, and change management, developing skills that are highly transferable to advanced roles in clinical pharmacy, healthcare consulting, or population health management.

🎯 Requirements

• Bachelor’s degree or advanced degree (PharmD., M.S.) in pharmacy required
• 3+ years of retail or hospital pharmacy experience OR 1+ years of managed care pharmacy experience required
• Current, unrestricted state pharmacist registration (PHARM-R) required upon hire
• Clinical pharmacy experience in a managed healthcare environment preferred
• 3+ years of managed care pharmacy or pharmacy benefit management experience preferred

🏖️ Benefits

• Competitive pay range of $107,700.00 - $199,300.00 per year, adjusted based on skills, experience, education, and job-related factors
• Comprehensive benefits package including health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off plus holidays
• Flexible work approach with remote, hybrid, field, or office schedules; this role is hybrid with 50% travel required to local pharmacies in New York
• Commitment to diversity, equity, and inclusion as an equal opportunity employer
• Opportunity to impact the health of 28 million members through meaningful pharmacy quality improvement initiatives

Skills & Technologies

Remote

Degree Required

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Centene Corporation

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About Centene Corporation

Centene Corporation is a publicly traded managed-care enterprise that arranges health-benefit programs for government-sponsored and privately insured individuals. Operating across all 50 U.S. states and internationally, the company focuses on under-insured and uninsured populations through Medicaid, Medicare, and Marketplace offerings. Its services include behavioral health, pharmacy benefits, vision, dental, telehealth, and in-house clinical programs. Centene partners with physicians, hospitals, and community organizations to coordinate cost-effective care, emphasizing data analytics and value-based reimbursement models. Headquartered in St. Louis, Missouri, it serves more than 25 million members, positioning itself as a leading intermediary between payers and healthcare providers.

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