Manager, Clinical Pharmacy Operations
About The Position
The Manager of Clinical Pharmacy Operations develops, implements, and administers clinical pharmacy tools and programs that support corporate and regional drug utilization and financial goals. This fully remote role directs clinical pharmacy activities through subordinate staff to improve pharmaceutical care quality and promote cost-effective medication utilization for members. The manager oversees the development, implementation, and maintenance of clinical pharmacy programs, coordinates efforts across departments, monitors staff quality assurance, and ensures programs and pharmacy benefit administration comply with applicable regulatory and compliance requirements. The role also oversees clinical recommendations and guidelines for Pharmacy and Therapeutics committee approval, monitors evidence-based pharmacy practice, and serves as a clinical pharmacy liaison to outside agencies and providers. The position requires a Doctor of Pharmacy degree, a current, valid, unrestricted Registered Pharmacist license for the assigned region(s), clinical pharmacy experience, progressively responsible managed care pharmacy experience, management experience, and public speaking experience.
Requirements
- Doctor of Pharmacy degree from an accredited school.
- One to three years of clinical pharmacy experience, including formulary development, drug utilization review, and/or medication therapy management.
- Four years in progressively responsible positions within managed care pharmacy, including a minimum of two years in a management role.
- Public speaking experience.
- Current, valid, and unrestricted state Registered Pharmacist license for the assigned region(s).
Nice To Haves
- People leadership experience.
- Strong background in managed care or PBM clinical pharmacy operations, including clinical edits, drug utilization review, prior authorization, claims adjudication, or formulary management.
- Experience with Medicaid requirements, pharmacy claims standards, PBM partners, and cross-functional teams.
Responsibilities
- Direct and manage clinical pharmacy activities through subordinate staff to enhance pharmaceutical care quality and promote cost-effective pharmaceutical utilization for members.
- Develop, implement, and maintain clinical pharmacy programs, including clinical quality assurance, formulary management, drug utilization review, compliance, and education programs.
- Coordinate clinical efforts with other department functional areas to ensure cohesive program implementation.
- Perform quality assurance monitoring of staff and validate that clinical pharmacy programs meet applicable regulatory and compliance standards, including Medicare Star ratings, HCQA HEDIS measures, and regulations.
- Oversee or develop clinical recommendations and guidelines for approval by the Pharmacy and Therapeutics committee.
- Monitor clinical advancements and changes in evidence-based pharmacy practice to support coverage of safe and effective pharmaceuticals and implementation of effective programs.
- Oversee compliant administration of the pharmacy benefit.
- Act as a clinical pharmacy liaison to outside agencies and providers and as the primary point of contact for clinical pharmacy issues in the responsible area, as needed.
- Perform other duties as assigned.
- Comply with all policies and standards.
Benefits
- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off
- Holidays
- Flexible approach to work with remote, hybrid, field, or office work schedules
- Additional forms of incentives may be included in total compensation, subject to eligibility
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Ph.D. or professional degree
