Remote Clinical Data Reviewer Jobs in Mobile, AL

WHO IS GUIDEHEALTH? 

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.  

Join us as we put healthcare on a better path!!  

About the Role:

We are seeking a highly motivated and detail-oriented Clinical Pharmacist with a PharmD degree and experience in HEDIS medication adherence initiatives. The ideal candidate will play a crucial role in improving medication adherence rates among patients, ensuring compliance with HEDIS/Medicare quality measures, and driving overall health outcomes.

Key Responsibilities:

HEDIS Quality Measures:

•  Lead efforts to improve HEDIS medication adherence and other pharmacy quality measures, including but not limited to adherence to antihypertensive, cholesterol-lowering, and diabetes medications.
•  Analyze medication adherence data, identify gaps in care, and implement targeted interventions to improve adherence rates.
•  Collaborate with healthcare providers, care managers, and other stakeholders to develop and implement strategies that promote adherence to prescribed therapies.

Patient Engagement:

•   Conduct medication therapy management (MTM) sessions to address barriers to adherence, provide patient education, and ensure understanding of medication regimens.
•   Work directly with patients to identify and resolve issues related to medication adherence, including cost, side effects, and complex dosing schedules.
•  Utilize motivational interviewing techniques to encourage patients to adhere to their prescribed medication regimens.

Data Analysis & Reporting:

•    Monitor and track HEDIS performance metrics, generating reports to assess the effectiveness of interventions and programs.
•   Use electronic health records (EHR) and pharmacy data to identify patients at risk of non-adherence and develop action plans.
•    Provide regular updates to leadership on progress towards HEDIS goals and make recommendations for improvement.

Collaboration & Training:

•   Serve as a medication adherence subject matter expert (SME) within the organization.
•   Provide training and support to other pharmacists, care managers, and clinical staff on best practices in medication adherence.
•  Participate in cross-functional teams focused on quality improvement, population health management, and value-based care initiatives.

WHAT YOU'LL NEED TO HAVE 

• Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy.
• Active pharmacist license in one or more of the following states: TX, PA, AL, TN.
• Minimum of 2 years of experience in HEDIS-related medication adherence work, quality improvement, or population health.
• Strong knowledge of HEDIS measures, particularly those related to medication adherence.
•  Proficiency in using EHR systems and data analysis tools.
•  Excellent communication, problem-solving, and organizational skills.
• Ability to work independently as well as in a team-oriented environment.
•  Experience with motivational interviewing or other patient engagement techniques is a plus.

WOULD LOVE FOR YOU HAVE 

• Experience in a managed care setting, pharmacy benefits management (PBM), or a healthcare quality improvement role.
• Certification in Medication Therapy Management (MTM), Certified Geriatric Pharmacist (CGP), or other relevant credentials.
• Understanding of value-based care models and their impact on medication adherence.

The salary range for this role is between $120,000.00 to $130,000.00 per year.

ALIVE with Purpose: How We Thrive at Guidehealth 

At Guidehealth, our values come to life in everything we do. 

• We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. 
• Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. 
• With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. 
• At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. 
• And through Empathy in Action, we build stronger connections with those who count on us. 
• This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth. 

BENEFITS:

While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
• Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
• Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
• Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.

All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits.

COMPENSATION:

The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT 

Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.  

OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA

This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties.  For any security-specific roles, the responsibilities would be further defined by the hiring manager. 

As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements.

REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements. 

SECONDARY EMPLOYMENT

At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest. 

To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.