Manager – Clinical Pharmacy
Location
Missouri
Posted
36 days ago
Salary
$139.8K - $176.9K / year
Professional Certificate3 yrs expEnglish
Job Description
• Insuring evidence-based medication utilization among our membership through prior authorization criteria development and implementation
• Upholding defined clinical turnaround times and goals set forth in current contracts, accreditation standards and corporate guidance
• Providing clinical insight and leadership to direct reports
• Reviewing formulary, utilization management, and drug pipeline guide GEHA decision making
• Responsible for the day-to-day clinical management of the pharmacy benefit, team, and deliverables
• Provide clinical guidance, support and oversight to the assigned clinical team
• Independently completes accurate and comprehensive clinical review of internal and external impacts; provides recommendations as applicable
• Serves as clinical pharmacy SME on projects and clinical care activities
• Works across internal teams and partners to align strategic initiatives related to HEDIS and member experience optimization
• Works in partnership with division leadership to implement and maintain regulatory compliance (AAAHC, OPM, OIG, etc)
Job Requirements
- Doctor of Pharmacy (PharmD) degree from an ACPE-accredited School of Pharmacy
- Candidate must be licensed, or eligible for licensure, within the state of Missouri
- Candidate must have 3 years of health plan experience
- Candidate must have experience leading direct reports or cross-functional teams
- Candidate must have experience with healthcare claims data (medical and pharmacy)
- Preferred MBA or demonstrated business background
- Knowledge of the Medicare Advantage benefits
- Knowledge of NCQA (HEDIS®) technical specifications
- Federal Employee Health Benefit (FEHB) experience
- Proficient in Microsoft Office (Outlook, Word, Excel, Vizio and Microsoft Teams)
Benefits
- Competitive pay/salary ranges
- Incentive plan
- Health/Vision/Dental benefits effective day one
- 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
- Robust employee well-being program
- Paid Time Off
- Personal Community Enrichment Time
- Company-provided Basic Life and AD&D
- Company-provided Short-Term & Long-Term Disability
- Tuition Assistance Program
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