Vice President, Pharmacy

Career Center•Franklin, TN

About The Position

ESSENTIAL JOB DUTIES: To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation. Develop and communicate health services team objectives. Establish performance goals for health services staff; ensure continuous feedback regularly, throughout the year. Implement and manage cost-effective and high-quality utilization, care, disease management and other clinical programs, including health plan performance reviews, corrective actions, and plans. Set performance standards and implement processes to measure qualitative performance regularly and consistently. Implement processes to identify developmental needs of team members and a mean of addressing areas of improvement. Manage cost of care and utilization to achieve the most effective financial performance while ensuring appropriate quality of care. Manage financial performance on a unit cost and operating basis. Develop and manage clinical operating budget; participate in strategic planning and clinical model and policy development as requested by leadership. Avoid payment of performance penalties and optimize opportunities to earn incentives. Other duties as assigned

Requirements

10+ years minimum experience in a management position in managed care, post-degree.
Experience with State and external accreditation managed care audits and reviews required.
Experience with writing and implementing program level policy and procedures required.
Track record of strong clinical utilization and care program management, general management, supervisory, team building and leadership skills
Excellent writing and communication skills.
Direct clinical experience in multiple settings and levels of care, including post-acute care settings.
Knowledge of relevant federal and state regulations pertaining to managed care and insurance products.
Proficient with computer and software programs (e.g.; Microsoft Word, Excel) and the Internet required.
Experience applying medical management treatment guidelines, such as InterQual / McKesson, Milliman, or other practical management guidelines required.

Responsibilities

Develop and communicate health services team objectives.
Establish performance goals for health services staff; ensure continuous feedback regularly, throughout the year.
Implement and manage cost-effective and high-quality utilization, care, disease management and other clinical programs, including health plan performance reviews, corrective actions, and plans.
Set performance standards and implement processes to measure qualitative performance regularly and consistently.
Implement processes to identify developmental needs of team members and a mean of addressing areas of improvement.
Manage cost of care and utilization to achieve the most effective financial performance while ensuring appropriate quality of care.
Manage financial performance on a unit cost and operating basis.
Develop and manage clinical operating budget; participate in strategic planning and clinical model and policy development as requested by leadership.
Avoid payment of performance penalties and optimize opportunities to earn incentives.
Other duties as assigned