Pharmacy Quality and Contract Oversight Manager

3 weeks ago


Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time
Job Summary

We are seeking a highly skilled Pharmacy Quality and Contract Oversight Manager to join our team at Presbyterian Healthcare Services. As a key member of our pharmacy operations team, you will be responsible for ensuring the quality and compliance of our pharmacy services, as well as overseeing our contracts with pharmacy benefit managers (PBMs).

Key Responsibilities
  • Develop and maintain a PBM oversight program to ensure compliance with policies, contractual obligations, and regulatory requirements.
  • Conduct ongoing monitoring, auditing, and reporting of pharmacy operations and PBM services.
  • Develop and implement corrective action plans to address any issues or non-compliance.
  • Serve as a point of contact for pharmacy PBM sub-contracted services and report audit findings and progress to appropriate departments.
  • Liaise between Pharmacy Services, clients, and PBMs to ensure timely reporting, acknowledgement, and resolution of complaints and grievances.
Requirements
  • Bachelor's degree required.
  • Five+ years of experience in the pharmacy department of a health plan or PBM, or equivalent experience in auditing, compliance, or healthcare.
  • Detailed coordination, organizational, and project management skills.
  • Experience in process improvement methodologies.
  • Ability to work cooperatively with other employees and departments and function effectively under pressure.
  • Familiarity with Windows and Microsoft Office products.
Why Join Us

At Presbyterian Healthcare Services, we value our employees' differences and find strength in the diversity of our team and community. We offer a comprehensive benefits package, including medical, dental, vision, short-term and long-term disability, group term life insurance, and other optional voluntary benefits. Our Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.



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