Descripción de la oferta: Oversees interventions and/or calls to clients (beneficiaries, providers, pharmacies) to promote the correct use of medications and follow the prescription to increase adherence in the identified population, which results in a significant impact on the star rating for the company. Participates in the management of clinical interventions with beneficiaries/providers, offering recommendations for the use of Statin Use in Persons with Diabetes (SUPD), Statin Use in Persons with Cardiovascular Disease (SPC), Concurrent Use of Opioids and Benzodiazepines (COB) and/or polypharmacy’s measures (Anticholinergic Burden (ACH) or Central Nervous System Active Medications (CNS)).

Responsabilidades: • Participates in clinical interventions management with beneficiaries and providers, offering recommendations related to high-impact quality measures, including SUPD, SPC, COB, and/or polypharmacy’s measures (ACH and CNS). • Identifies patients who are not adhering to medication therapy related to key quality measures (diabetes, hypertension, and cholesterol), to proactively improve adherence and positively impact the company’s Star Ratings. • Performs clinical interventions for clients (beneficiaries, pharmacies, and physicians) related to medication use, where beneficiary adherence directly impacts Star Ratings. • Participates in pharmacy or company-led initiatives that may impact Star Ratings, such as educational talks or clinical activities with beneficiaries or their physicians, aimed at improving medication adherence inside or outside the company. • Administers and documents clinical interventions in the Rx Effects and Aspect VIA tools, ensuring accurate tracking and compliance. • Educates and supports patients so they can obtain their prescribed medications according to clinical and administrative criteria established by the pharmacy department. • Attends and manages the referral process within the system when beneficiaries need adherence-related medication refills through pharmacies or when members require new prescriptions coordinated with physician offices. • Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. • May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.