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 remote pharmacist position supports the Louisiana Medicaid pharmacy program, requires residence in Louisiana, and leads three direct reports: a pharmacist, pharmacy coordinator, and project coordinator. The manager serves as a pharmacy subject matter expert and partners with Louisiana Medicaid regulators, health plan executive leadership, Government Relations, Quality, Finance, and Actuarial teams on regulatory requirements, pharmacy initiatives, quality measures, financial planning, and member health outcomes. The role operates Monday through Friday during Central Time business hours and may require travel to Baton Rouge, Louisiana. The manager directs clinical pharmacy activities through subordinate staff to enhance pharmaceutical care quality and promote cost-effective medication utilization. The position develops and maintains clinical pharmacy programs, coordinates clinical work across departments, monitors staff quality and program compliance, oversees clinical recommendations and guidelines for Pharmacy and Therapeutics committee approval, monitors evidence-based pharmacy practice developments, oversees compliant administration of the pharmacy benefit, and serves as a clinical pharmacy liaison to outside agencies and providers. Additional work includes supporting Government Relations with pharmacy-related legislative talking points and meetings as needed; collaborating on provider engagement and clinical strategies; participating in monthly Lag Prep and pharmacy metric reviews; ensuring compliance with Louisiana clinical policy guidelines and Drug Information requirements; maintaining Medicaid pharmacy business-process policies and procedures; and monitoring CPS compliance with the Louisiana Medicaid contract. Other duties may be assigned, and the employee must comply with all policies and standards.
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 managed care pharmacy positions, including a minimum of two years in a management role.
- Public speaking experience.
- Must reside in Louisiana.
- Must hold and maintain an active, current, valid, and unrestricted Louisiana Registered Pharmacist license.
- Must work full-time and have at least five years of experience practicing as a pharmacist in a retail setting, including managerial experience.
- Ability and willingness to travel to Baton Rouge, Louisiana, as required.
- Strong leadership and employee engagement skills and the ability to lead effectively through change.
Nice To Haves
- Significant managed care experience, preferably in pharmacy health plan leadership.
- Previous pharmacy benefit manager (PBM) experience.
- Proficiency in all Microsoft Office applications.
Responsibilities
- Direct and manage clinical pharmacy activities through subordinate staff to improve pharmaceutical care and promote cost-effective medication utilization.
- Develop, implement, and maintain clinical pharmacy programs, including clinical quality assurance, formulary management, drug utilization review, compliance, and education.
- Coordinate clinical efforts with other functional areas to implement cohesive programs.
- Monitor staff quality assurance and verify that clinical programs meet applicable regulatory and compliance standards, including Medicare Star ratings, HCQA HEDIS measures, and regulations.
- Oversee or develop clinical recommendations and guidelines for Pharmacy and Therapeutics committee approval.
- Monitor clinical advancements and evidence-based pharmacy practice changes to support appropriate coverage of safe and effective pharmaceuticals and implementation of effective programs.
- Oversee compliant administration of the pharmacy benefit.
- Serve as a clinical pharmacy liaison to outside agencies and providers and as the primary contact for clinical pharmacy issues in the responsible area.
- Partner with Louisiana Medicaid regulators, health plan executive leadership, Government Relations, Quality, Finance, and Actuarial teams on regulatory requirements, pharmacy initiatives, quality measures, financial planning, and member health outcomes.
- Support Government Relations with pharmacy-related legislative talking points and meetings as needed.
- Collaborate on provider engagement and clinical strategies.
- Participate in monthly Lag Prep and pharmacy metric reviews.
- Ensure compliance with Louisiana clinical policy guidelines and Drug Information requirements.
- Maintain policies and procedures for Medicaid pharmacy business processes.
- Monitor CPS compliance with the Louisiana Medicaid contract.
- Lead three direct reports: a pharmacist, pharmacy coordinator, and project coordinator.
- Perform other duties as assigned and comply with all policies and standards.
Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off and holidays
- Flexible approach to work schedules, including remote, hybrid, field, or office arrangements
- Additional forms of incentives may be included in total compensation
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Ph.D. or professional degree
