Manager – Clinical Pharmacy

ManagerManagerFull TimeRemoteTeam 1,001-5,000Since 1937H1B No SponsorCompany SiteLinkedIn

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

Related Job Pages

More Manager Jobs

Full TimeRemoteTeam 1,001-5,000Since 30+ yearsH1B Sponsor

Care Manager collaborating on healthcare delivery in Mississippi

Mississippi
$56.4K - $90.4K / year
Full TimeRemoteTeam 5,001-10,000Since 1921H1B No Sponsor

Regional Activation Manager executing marketing programs for national accounts team

Minnesota
$107.7K - $161.5K / year
Manager36 days ago
Full TimeRemoteTeam 1,001-5,000Since 1986H1B Sponsor

Case Manager assisting enrollees of a Medical Fund at Public Consulting Group

New York
$78.5K - $100K / year

Case Manager, Registered Nurse – NJ, PA or WV

CVS Health

Bringing our heart to every moment of your health.

Manager36 days ago
Full TimeRemoteTeam 10,001+Since 1963H1B No Sponsor

Case Manager focusing on community-based care management for CVS Health members.

New Jersey + 3 moreAll locations: New Jersey, Pennsylvania, Virginia, West Virginia
$60.5K - $129.6K / year