Clinical Pharmacy Manager

Health Care Service Corporation•Nashville, TN

3d•$102,000 - $184,300•Hybrid

About The Position

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for directing the development, maintenance and on-going oversight for clinical and operational programs and processes for enterprise pharmacy government programs of Medicare with a focus on PDE Stars. This includes but is not limited to CMS stars, Medicare operational and reporting activity, programs for prescribers and network of pharmacies, pharmacy cost and utilization trends monitoring, clinical programs with emphasis on disease management and clinical outcomes, oversight of contracted pharmaceutical benefit managers (PBM), and for the overall effectiveness of the government pharmacy operations and programs. Additionally, this position requires collaboration with management and professional staff within HCSC and with external health care providers to improve quality of healthcare, optimize health outcomes and improve the cost of care.

Requirements

Registered Pharmacist in the state
Corporate Pharmacist experience including experience with pharmacy practice guidelines or practice parameters; review of formulary programs, Pharmacoeconomics; or pharmacy quality improvement processes/techniques
Knowledge of medication use evaluation principles
Drug information skills
Analytical skills
Experience using window-based word processing, spreadsheets and relational database software
Verbal and written communications skills
Ability to remain at a workstation and perform computer entry for long periods of time, as required
Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management.
Extensive knowledge of the CMS Star Rating System, including Part D Measures
Extensive knowledge of pharmacy claims data, along with a working knowledge of other health plan data, such as eligibility and medical claims
Strong project management, organizational, analytical, communication, and relationship management skills
Must be able to manage ambiguity and work in fast-paced environment
Able to organize and manage multiple priorities

Nice To Haves

PDE Stars vendor management experience
Experience engaging diverse stakeholders to drive performance
Financial acumen including ability to forecast expenses

Responsibilities

Directing the development, maintenance and on-going oversight for clinical and operational programs and processes for enterprise pharmacy government programs of Medicare with a focus on PDE Stars.
CMS stars, Medicare operational and reporting activity
Programs for prescribers and network of pharmacies
Pharmacy cost and utilization trends monitoring
Clinical programs with emphasis on disease management and clinical outcomes
Oversight of contracted pharmaceutical benefit managers (PBM)
Overall effectiveness of the government pharmacy operations and programs
Collaboration with management and professional staff within HCSC and with external health care providers to improve quality of healthcare, optimize health outcomes and improve the cost of care.