Sr Manager, Clinical Pharmacy Operations

Point32Health

15d

About The Position

Under the direction of the Director, Clinical Pharmacy Operations, the Senior Manager, Clinical Pharmacy Operations is responsible for managing a team focused on the execution of clinical pharmacy programs and strategies to mitigate cost, improve adherence, and maintain affordability. Leads the implementation and maintenance of evidenced based, cost-effective program for all lines of business in all market segments. Guides clinical pharmacy team in the implementation of clinical programs, aligned with enterprise goals, including medical cost reduction and administrative simplification for members and providers. Ensures compliance with state and federal regulatory and accreditation requirements in all geographies. Collaborates with PBM to optimize member experience and clinical outcomes. Directs support functions for the Pharmacy and Therapeutic’s committee in collaboration with the pharmacy medical director. Leads and manages the work of the clinical pharmacy team, effectively delegating as appropriate and holding team members accountable for meeting deliverables and achieving results. Sets priorities and ensures that the key deliverables of the team stay on track.

Requirements

• Licensed health care professional (e.g., PharmD, RPh or RN) with current unrestricted license in state of residence.
• BS in Nursing, Doctorate degree in Pharmacy (PharmD), or Registered Pharmacist (RPh)
• 8-10 years’ to include 6 years’ related experience in pharmacy, and 2 years of supervisory experience.
• Strong verbal and written communication skills
• Work cooperatively as a team member across multiple levels within the organization
• Results orientation - strives to meet business goals
• Critical and Analytic thinking – must understand cause and effect, internal and external impact of business changes and Point32Health information systems
• Comprehensive knowledge of health policy, sufficient to make decisions regarding Plan benefit structures and coverage issues.
• Influencing others – particularly those outside of direct reporting relationships
• Ability to define training needs, develop training materials and administer training to small groups.
• Strong communications skills (formal and informal, written and verbal)
• Coaching and Mentoring - primarily of direct reports, but also of others
• Must have commitment to excellence in customer service
• Considers creative alternatives to traditional/conventional practices and takes risk when appropriate to the situation.
• Ability to handle multiple demands--must be able to balance multiple priorities
• Expert knowledge of the principles and practices of pharmaceutical science.
• Working knowledge of managed care and policy development.
• Requires analytical ability, highly developed oral/written communication skills.
• Must be self-motivated and capable of working independently with minimal supervision.
• Must be capable of organizing, facilitating, and managing several projects simultaneously.
• Requires a high degree of initiative and excellent judgment to make decisions regarding clinical pharmacy issues in an extremely complex and often politically charged environment.
• Must be flexible and able to constantly review and reset priorities; often daily.
• Must be able to handle multiple projects simultaneously.
• Ability to appropriately identify emergency situations and follow through with the appropriate protocol.
• Must be able to work independently as well as cooperatively as a team member.
• Excellent interpersonal skills, cross-departmental skills required; a high level of diplomacy is necessary to anticipate, analyze and effectively resolve difficult situations and politically sensitive concerns.
• Frequent communications with Point32Health staff.
• Capable of communicating with physicians, pharmacists, and other health care specialists as well as a broad range of non-health care professionals.
• Ability to maintain harmonious working relationships and to communicate effectively both verbally and in writing with health care professional, other departments, network providers, state and federal regulatory and enforcement agencies, pharmaceutical manufacturers, and professional colleagues.
• Ability and willingness to work irregular hours and to travel in state and out-of-state for job-related purposes, as necessary.
• Must be able to work under normal office conditions and work from home as required.
• Occasional evening, weekend, early morning, or extended day work may be required.
• Must hold a valid driver’s license and have access to and ability to drive an automobile during regular working hours and irregular hours as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

Nice To Haves

• Master’s degree in business and/or health policy
• 1 - 2 years’ managed care or PBM work experience.
• Experience supervising in an office or clinical environment is desirable.
• Experience with multiple lines of business such as commercial, Medicare and Medicaid are desirable.
• Expertise in business process changes and leading people is also desirable.

Responsibilities

• Lead the maintenance of enterprise formularies and pharmacy programs, for all lines of business and geographies.
• Lead the annual review of all formularies and clinical pharmacy strategies, including a competitive analysis, cost-benefit review of programs, and trend review by therapeutic class.
• Work with Pharmacy Benefit Manager (PBM) to monitor pharmacy spend and performance to identify opportunities for improved management.
• Ensure formulary management activities meet state and federal requirements.
• Identify initiatives for medical cost reduction, administrative cost reduction and/or market competitiveness.
• Lead the business evaluation and implementation through collaboration and communication with other departments and stakeholders and Pharmacy TCOC (Total Cost of Care) team.
• Represent clinical pharmacy interests at inter-departmental meetings and on project teams.
• Identify implications for Pharmacy Services department and facilitates/coordinates follow-up with others in the department. Disseminate information and provides periodic updates as needed.
• Hire, train, supervise and evaluate the activities of the Clinical Pharmacy Team staff.
• Provide coaching, feedback, and direction to staff to insure the successful achievement of their goals and that of Point32Health.
• Prioritize projects and initiatives and support staff in the resolution of escalated issues.
• Serve as a role model for staff and foster a collaborative and team-based approach both within the Department and interdepartmentally.
• Effectively manage change and constant prioritization based on strategic and operating goals
• Direct the research and analysis of identified problems and issues, the validation of findings and the development and communication of plans for problem resolution.
• Support staff in the identification and verification of problems and provide guidance in the development and implementation of appropriate solutions.
• Identify for the Director those issues of broader complexity and/or sensitivity which may require action by the Director and recommend solutions for those issues having broader complexity or ramifications.
• Participate in and/or lead departmental and interdepartmental meetings, including but not limited to Pharmacy & Therapeutics Committee, Drug Coverage Committee, Specialty Pharmacy committees, and Pharmacy Compliance.
• Oversees team compliance with all federal and state laws and accrediting bodies and keep abreast of marketplace developments and regulatory and licensing requirements as it relates to Clinical Pharmacy and formulary management.
• Other duties and projects as assigned.

Benefits

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Ph.D. or professional degree
• Number of Employees: 1,001-5,000 employees