Health Plan Pharm Svcs Mgr (Remote in Washington) Job Description

Posted today

Health Plan Pharm Svcs Mgr (Remote in Washington)

Molina Healthcare - ,

Job Description

JOB DESCRIPTION

Job Summary

The Pharmacy Manager, Health Plan Pharmacy Services is an integral role of the Health Plan leadership team, assisting the team in understanding pharmacy quality, cost effectiveness and compliance and working closely with the Pharmacy Director or AVP to ensure that the Health Plan Pharmacy Program is consistent with Molina's overall pharmacy strategy.

KNOWLEDGE/SKILLS/ABILITIES

Provides oversight and direction to Centralized Pharmacy Utilization Management team
Acts as liaison to internal and external customers to ensure prompt resolution of identified issues and serves as the first point of contact for internal departments.
Assists Director/AVP in the collection and tabulation of data for reporting purposes and maintains files of confidential information submitted for review.
Assures that activities and processes are compliant with NCQA guidelines and Molina policies and procedures and promotes best practice measures to ensure consistency.
Interviews job applicants and provides hiring recommendations to Director/AVP.
Communicates with practitioners, pharmacists, and drug representatives
Collaborates with and keeps Director/AVP apprised of operational issues, including staffing resources, program and system needs, and regulatory changes.
Develops policies and procedures as needed.
Participates in Quality Management and Health Education programs including, but not limited to, NCQA Accreditation, HEDIS, and Disease Management programs company wide.
Attends State and Health Plan meetings as directed by Director/AVP.

JOB QUALIFICATIONS

Required Education

Doctor of Pharmacy from an accredited pharmacy school or bachelor's degree in Pharmacy with equivalent experience.
Continuing education required to maintain an active pharmacist license.

Required Experience

Minimum 5 years' experience as a Pharmacist, including at least 3 years in health care delivery.
2+ years of leadership experience
Experience designing, implementing, monitoring, and evaluating projects.
Working knowledge of medical/pharmacy terminology, State and NCQA guidelines

Required License, Certification, Association

Active and unrestricted Pharmacist license in good standing.
Must be free of sanctions from Medicaid or any other government program and without restrictions that would affect job performance.

Preferred Experience

5 years in the healthcare industry, managed care organization or equivalent experience.
Knowledge of or experience with decision analysis and data analysis tools, such as SQL, MS Access, Excel.
Medicaid and Marketplace experience

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.