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Hospitals and Health Care

Clinical Operations Specialist

West Des Moines, IAHybridFull TimeEntry-level (exp-based)Posted 1 month ago

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Required skills

  • Pharmacist
  • clinical service design
  • clinical configurations
  • clinical operations specialist
  • Insight clinical engine
  • clinical opportunity generation
  • clinical rules
  • new clinical programs
  • CMS guidelines
  • quality measures

Nice to have

  • MTM

Role summary

The Clinical Operations Specialist, a pharmacist, is responsible for designing and managing clinical services and configurations, particularly for the Insight clinical engine. This role involves generating clinical opportunities, developing and maintaining clinical rules, and implementing new clinical programs in compliance with CMS guidelines and quality standards. The specialist will also develop service attributes, conceptualize new covered services, and define requirements for clinical reporting enhancements. Collaboration with Product, Clinical Program Management, Quality Management, and technology teams is essential. The role requires strong organizational, communication, and time management skills, with the ability to work both independently and collaboratively. A Pharmacy Degree and an active pharmacist license are required, with experience in MTM being preferred.

Job Details: Job Location: W Des Moines Office - West Des Moines, IA, Salary Range: Undisclosed, JOB SUMMARY Pharmacist who manages clinical service design and associated clinical configurations, serves as clinical operations specialist for both internal and external stakeholders, provides ongoing support and management of the Insight clinical engine, oversees and manages clinical opportunity generation processes Develop and maintain clinical rules for the Insight Clinical Engine Design and implement new clinical programs that align with client requests, network pharmacist capabilities and company priorities Implement and maintain clinical programs in accordance with CMS guidelines and regulations, quality measures, and clinical guidelines Develop and maintain service attributes Develop concepts for new covered services and coordinate with Product, Clinical Program Management, Quality Management, and technology teams to define requirements Continually evaluate clinical reporting and define requirements for enhancements, as needed Participate in national industry meetings, trade shows, and client visits, as needed Answer clinical questions from the Network Qualifications: KNOWLEDGE & REQUIREMENTS Experience with MTM, preferred Proficient in Microsoft Office products Strong organizational and time management skills Ability to work collaboratively and independently while managing multiple projects, assignments, and responsibilities Excellent communication and interpersonal skills Highly organized Must be able to manage competing demands and multiple priorities, while maintaining a strong attention to detail Solution oriented Excellent time management skills Prioritization skills and goal setting Adaptable to learn new processes, concepts, and skills Ability to communicate across all levels of an organization, demonstrating professionalism and good judgment at all times Travel Requirements Domestic and or International, up to 10% EDUCATION & EXPERIENCE REQUIREMENTS Minimum years of work experience: 1 year Minimum level of education or education/experience: Pharmacy Degree (BS or PharmD) Active pharmacist license in good standing with a state board of pharmacy What’s In It For You? Medical, Dental and Vision Plans Voluntary Benefits HSA & FSA Fertility & Family Planning Benefits Paid Parental Leave Adoption Assistance Program Employee Resource Groups Flex PTO for Exempt Associates & up to 15 PTO days in first year of employment for non-exempt associates 11 Paid Holidays Corporate Wellness Program 401k Employer Match & Roth Option Available – immediate eligibility #LI-HYBRID

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