Director, Pharmacy

AmTrust Financial Services•Southington, CT

8d•$130,000 - $155,000•Remote

About The Position

The Director of Pharmacy is responsible for supporting the AVP of Medical Cost Containment in the implementation, process improvement, and optimization of clinical programs. The Director of Pharmacy will be responsible for analytic measurement and improvement of medical management of their assigned programs. These programs may include pharmacy and other associated operational processes and interventions. This role will achieve outcomes by focusing on analytics, clinical operations, and development of new programs to support organizational vision, and cost savings. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization.

Requirements

PharmD. or RPH
Experience with Workers Compensation insurance carrier setting or related industry
Ability to lead team of pharmacists and any necessary process improvement efforts needed to improve organizational outcomes
Demonstrated results in developing strategic plans and executing key initiatives
Proficient in data evaluation and visualizations
Excellent English communication skills, written and verbal, as well as strong analytic, documentation, and organizational skills
Efficient with multitasking between projects
Proficiency in all Microsoft Office products including Project, Word, Excel, PowerPoint, Visio, and SharePoint
Ability to prepare and effectively communicate presentations, interpret/develop reports, metrics and improvement plans, and to interact collaboratively and work effectively with a multi-functional team and throughout the organization; foster an environment of shared responsibility and accountability

Nice To Haves

2+ years of managing projects and/or vendor relationships
2+ years of experience writing SQL queries, creating stored procedures, views, and functions
2+ years of management experience preferred
Project Management Office (PMO) experience
Knowledge of workers' compensation laws and regulations, medical billing (ICD9/10, CPT, HCPCS)
Experience with State and external accreditation managed care audits and with writing and implementing program level policy and procedures

Responsibilities

Serve as a business owner for medical product management needs specific to pharmacy program and establishing key performance indicators, identifying opportunities, and driving business goals
Manage a team of 8 pharmacists through a remote setting, overseeing a countrywide prior authorization program specific to workers compensation claims.
Monitor, analyze, and trend clinical program data to assist in the development, implementation, and driving of key initiatives.
Evaluate new and emerging regulations as they impact the program and problem solve for implementing change and producing outcomes
Optimize clinical programs for nurse and adjuster efficiency, streamlined injured employee experience, and positive claim outcome
Manage day-to-day issues with clinical program management interfacing with vendors and internal staff
Identifies best practices and trends in the industry, participates in evaluating new and emerging technologies and treatments to determine possible incorporation into programs
Participating in office managed care and clinical operational reviews
Manages project development/enhancements through coordination with WC operations
Keeps current with market trends and demands
Performs other functionally related duties as assigned