Location: Remote in EST Time zone. •Works with internal staff across multiple departments to assist with data sources, processes and activities required to meet regulatory compliance requirements with a key focus on Utilization Review (UR) /Utilization Management (UM) • Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting 100% of work activities on the computer. •Data gathering requires navigation through multiple system applications. •Prior experience in performing data collection is preferred.

This position requires a bachelor's degree and 2-4 years of experience in healthcare administration, nursing, public health or in a related area. Managed care experience preferred. In collaboration with clinical and quality leaders, the Program Manager manages the implementation and administration of population health programs development, supports the state strategic pillars, drives improvements in health outcomes, and strengthens operational initiatives that are required under state contract, RFP, or other state/national standards. Reporting to Population Health Officer, the successful candidate will work directly with cross functional teams to ensure deliverables fall within the applicable scope, timeline and budget; coordinate with state, national and internal partners to ensure all programs are designed and delivered to meet goals, measures and outcomes with defined policies, procedures, workflow, training materials and reporting in accordance with corporate, state or other requirements.

• At least 4 years of experience as clinical MTM pharmacist. (Management experience preferred) • Familiar with driving Part D Star measures. Specifically, SUPD, SPC, and CMR. • Understanding of pharmaceutical and medical vocabulary • Clinical experience in medication review.