Director of Pharmacy Health Plans
1 week ago
Job Summary
The Director of Pharmacy is responsible for providing clinical responsibility of all pharmacy programs and services including, oversight of formulary development and maintenance, quality assurance programs, Medication Therapy Management program, clinical services provided by PBM, specialty drugs management initiatives, and Maryland Medicaid Value Based Purchasing (VBP) and Medicare Part D stars Program. Other responsibilities include oversight of the P&T Committee, Corrective Managed Care program and collaboration with medical management on data integration, disease management, and outcome projects. Serves as a resource to the CMO for medication use policy activities dedicated to improved clinical and economic outcomes related to drug therapy.
Qualifications
- Requires a Doctor of Pharmacy (PharmD) degree.
- Current Maryland licensure as a registered pharmacist
- Five years clinical experience required, with at least two years in a managed care setting.
- Two years’ experience in formulary and drug utilization management. Two years’ supervisory/management experience.
- Requires strong knowledge of healthcare/managed care business processes and terminology, including health delivery systems, benefit design, utilization management, medication adherence, quality improvement and all ancillary clinical services.
- Requires knowledge of managed care pharmacy including Medicare Part D, Medicaid, and commercial products formulary management, drug utilization management, and quality assurance programs. Requires knowledge of health plan accreditation requirements and HEDIS measures.
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