Pharmacy Programs Specialist

Clover Health

. Create, manage, and respond to cases and escalate to Clinical Pharmacists as needed .

Posted 9/17/2026full-timeRemote • United StatesMid-LevelSenior💰 $53,800 - $70,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medication management, regulatory compliance, and cross-functional collaboration within pharmacy operations. Proficient in data analysis and reporting to enhance clinical pharmacy quality metrics and support Medicare Part D initiatives.

Highest-signal resume keywords

National Certification (CPhT)Medication ManagementData Analysis and ReportingFluent in English and SpanishManaged Care Understanding

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medication ManagementData AnalysisQuality AssuranceRegulatory CompliancePharmacy Workflows

Soft Skills

Excellent Communication SkillsTeam CollaborationProblem-Solving

Tools & Technologies

Windows-Based ApplicationsPBM Platforms

Certifications & Qualifications

National Certification (CPhT)Pharmacy Technician License

Industry Keywords

Medicare Part DManaged CareClinical PharmacyCross-Functional MeetingsQuality Metrics

About the role

Key responsibilities & impact

Create, manage, and respond to cases and escalate to Clinical Pharmacists as needed
Support Medicare Part D Star measures by resolving medication management problems and providing recommendations based on profile review or patient interview
Represent the Pharmacy team in cross-functional meetings
Collect and present PBM delegated-function data and trends to propose process improvements
Deliver cross-functional initiatives and ad-hoc projects
Provide guidance on pharmacy clinical and regulatory workflows, policies, and processes
Liaise between the PBM Account Management Team and Clover Health and escalate issues for resolution
Organize pharmacy team meetings with internal and external partners
Distribute work and strategize completion of quality assurance projects
Maintain and update Part D content in the internal knowledge base
Lead educational training on Part D knowledge and vendor platforms
Participate in call center quality assurance reviews
Perform strategic work to increase MTMP Star measure
Navigate tools and platforms for task/queue-based work
Serve as a resource to peers and complete program/project-based work
Communicate issues to pharmacy leadership
File, review, and validate reports for Medicare compliance
Gather data and generate reports to improve clinical pharmacy quality metrics
Participate in training and orientation of new team members
Execute other assigned duties

Requirements

What you’ll need

National Certification (CPhT) Pharmacy Technician License (preferred)
At least three (3) years of experience working in pharmacy, managed care organization, medical office or in a hospital setting
Fluent in English and Spanish, both orally and in writing
Understanding of managed care
PC skills in Windows-based applications
Excellent written and oral communication skills
Ability to work Eastern Time (ET) hours; candidates in this time zone preferred

Benefits

Comp & perks

Competitive base salary
Equity opportunities
Performance-based bonus program
401(k) matching
Regular compensation reviews
Medical coverage
Dental coverage
Vision coverage
No-Meeting Fridays
Monthly company holidays
Mental health resources
Generous flexible time-off policy
Remote-first culture
Learning programs
Mentorship
Professional development funding
Regular performance feedback and reviews
Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
Reimbursement for office setup expenses
Monthly cell phone & internet stipend
Collaboration with global teams
Paid parental leave for all new parents